Sexually 

Transmitted 

Disease 

Surveillance 

2000 

Division of STD Prevention 

September 2001 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Disease Control and Prevention 

National Center for HIV, STD, and TB Prevention 

Division of STD Prevention 

Atlanta, Georgia 30333 

Centers for Disease Control and 

Prevention..................................................Jeffrey P. Koplan, M.D., M.P.H. 

Director 

National Center for 

HIV, STD, and TB Prevention ................................Harold W. Jaffe, M.D. 

Acting Director 

Division of STD Prevention............................................Jack N. Spencer
 

Acting Director 

Statistics and Data Management 

Branch ............................................................Owen J. Devine, Ph.D. 

Chief 

Melinda L. Flock, M.S.P.H. 

Unit Chief 

Rose Horsley 

Unit Chief 

Epidemiology and Surveillance 

Branch...............................................Stuart M. Berman, M.D., Sc.M. 

Acting Chief 

Surveillance and Special Studies 

Section ......................................Hillard Weinstock, M.D., M.P.H. 

Chief 

iii 
Copyright Information 

All material contained in this report is in the public domain and may be used and reprinted 

without special permission; citation to source, however, is appreciated. 

Suggested Citation 

Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2000. 

Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and 

Prevention, September 2001. 

Copies can be obtained from the Training and Health Communications Branch, National Center 

for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, 

Mailstop E-06, Atlanta, Georgia 30333. Printed copies can also be obtained through the Internet 

on-line ordering system at the web site listed below. 

This report is also available by Internet via the CDC home page at: http://www.cdc.gov/std/stats/ 

iv 
Foreword 

“STDs are hidden epidemics of enormous health and economic consequence in the United 

States. They are hidden because many Americans are reluctant to address sexual health issues in an 

open way and because of the biologic and social characteristics of these diseases. All Americans 

have an interest in STD prevention because all communities are impacted by STDs and all individuals directly or indirectly pay for the costs of these diseases. STDs are public health problems that lack 

easy solutions because they are rooted in human behavior and fundamental societal problems. Indeed, there are many obstacles to effective prevention efforts. The first hurdle will be to confront the 

reluctance of American society to openly confront issues surrounding sexuality and STDs. Despite 

the barriers, there are existing individual- and community-based interventions that are effective and 

can be implemented immediately. That is why a multifaceted approach is necessary to both the 

individual and community levels. 

To successfully prevent STDs, many stakeholders need to redefine their mission, refocus their 

efforts, modify how they deliver services, and accept new responsibilities. In this process, strong 

leadership, innovative thinking, partnerships, and adequate resources will be required. The 

additional investment required to effectively prevent STDs may be considerable, but it is negligible 

when compared with the likely return on the investment. The process of preventing STDs must be a 

collaborative one. No one agency, organization, or sector can effectively do it alone; all members of 

the community must do their part. A successful national initiative to confront and prevent STDs 

requires widespread public awareness and participation and bold national leadership from the 

highest levels.”1 

1

Concluding statement from the Institute of Medicine’s Summary Report, The Hidden Epidemic: 

Confronting Sexually Transmitted Diseases, National Academy Press, Washington, DC, 1997, p.43. 

v 
Preface 

Sexually Transmitted Disease Surveillance, 2000 presents statistics and trends for sexually transmitted diseases (STDs) in the United States through 2000. This annual publication is intended as a 

reference document for policy makers, program managers, health planners, researchers, and others 

who are concerned with the public health implications of these diseases. The figures and tables in 

this edition supersede those in earlier publications of these data. 

The surveillance information in this report is based on the following sources of data: (1) case reports from the STD project areas; (2) prevalence data from the Regional Infertility Prevention 

Programs, STD project areas, the National Job Training Program (formerly the Job Corps), the Jail 

STD Prevalence Monitoring Projects, the Men Who Have Sex With Men (MSM) Project, the U.S. 

Army, and the Indian Health Service; (3) sentinel surveillance of gonococcal antimicrobial resistance from the Gonococcal Isolate Surveillance Project (GISP); and (4) national sample surveys implemented by federal and private organizations. 

The STD surveillance systems operated by state and local STD control programs, which provide 

the case report data, are the sources of many of the figures and all of the statistical tables in this publication. These systems are an integral part of program management at all levels of STD prevention 

and control in the United States. Because of incomplete reporting, the number of STD cases reported to CDC is less than the actual number of cases occurring among the United States 

population. 

Sexually Transmitted Disease Surveillance, 2000 consists of four parts. The National Profile contains figures that provide an overview of STD morbidity in the United States. The accompanying text 

identifies major findings and trends for selected STDs. The Special Focus Profiles contain figures 

and text describing STDs in selected subgroups and populations that are a focus of national and state 

prevention efforts. The Detailed Tables provide statistical information about STDs at the state, 

county, city, and national levels. The Appendix includes the sources and limitations of the data used 

to produce this report. Included in this section, are Figures A1-A3 that show progress made by states in 

converting from hardcopy aggregate reporting to electronic line-listed data. 

Selected figures and tables in this document identify goals that reflect progress towards some of the 

Healthy People 2010 (HP2010) national health status objectives for STDs.1 Appendix Table A1 displays progress made towards the HP2010 Priority Area 25, for STDs. These objectives are used as reference points throughout this edition of Sexually Transmitted Disease Surveillance, 2000. 

Any comments and suggestions that would improve the usefulness of future publications are appreciated and should be sent to Director, Division of STD Prevention, National Center for HIV, STD, 

and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-02, 

Atlanta, Georgia, 30333. 

1U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government Printing 

Office, November 2000. 

vi 
Acknowledgments 

Publication of this report would not have been possible without the contributions of the State and 

Territorial Health Departments and the Sexually Transmitted Disease Control Programs, the Regional Infertility Prevention Programs, the U.S. Department of Labor, the Indian Health Service, the 

John Hopkins University Chlamydia Research Laboratory, and the U.S. Army, which provided surveillance data to the Centers for Disease Control and Prevention. 

This report was prepared by the following staff and contractors of the Division of STD Prevention, 

National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention: 

Charles Akers, Stu Berman, Susan Bradley, Jim Braxton, Sharon Clanton, Susan Conner, Deblina 

Datta, Darlene Davis, Owen Devine, Linda Webster Dicker, Melinda Flock, LaZetta Grier, Alesia 

Jester Harvey, James Heffelfinger, Rose Horsley, Kathleen Hutchins, Christopher Iverson, Richard 

Kahn, William Levine, Catherine McLean, Debra Mosure, LuEtta Schneider, Maya Sternberg, 

Katherine Stone, Emmett Swint, Susan Wang, Hillard Weinstock, and Akbar Zaidi. 

Production of this and previous reports would not have been possible without the valuable input 

of Judith R. Wasserheit and William Levine. 

vii 
Contents 

Foreword ................................................................. v
 

Preface .................................................................. vi 
 

Acknowledgments.......................................................... vii 
 

Figures in the National Profile ................................................. ix 
 

Additional Figures in the Special Focus Profiles .................................... x
 

Tables in the National Profile ................................................. xiii
 

Geographic Divisions of the United States ....................................... xvi 
 

National Overview of Sexually Transmitted Diseases, 2000 ........................... 1
 

National Profile 

Introduction ............................................................ 5
 

Chlamydia ............................................................. 7
 

Gonorrhea ............................................................ 15 
 

Syphilis............................................................... 25 
 

Other Sexually Transmitted Diseases ........................................ 35 
 

Special Focus Profiles 

Introduction ........................................................... 39 
 

STDs in Women and Infants............................................... 41 
 

STDs in Adolescents and Young Adults ...................................... 51 
 

STDs in Racial and Ethnic Minorities ........................................ 59 
 

STDs Among Men Who Have Sex with Men .................................. 65 
 

STDs in Persons Entering Corrections Facilities ................................ 69 
 

STDs in the South ...................................................... 75 
 

Tables 

National Summary Tables ................................................ 79 
 

Chlamydia Tables....................................................... 82 
 

Gonorrhea Tables ...................................................... 92 
 

Syphilis Tables ........................................................ 102 
 

Chancroid Tables...................................................... 125 
 

Appendix 

Sources and Limitations of Data........................................... 127 
 

NETSS Figures A1 - A3 ................................................. 134 
 

Healthy People 2010 Table A1............................................ 136 
 

Contributors.......................................................... 137 
 

viii 
Figures in the National Profile 

Chlamydia 

Figure 1. Chlamydia — Number of states that require reporting of Chlamydia
 

trachomatis infections: United States, 1987–2000 .................... 10 
 

Figure 2. Chlamydia — Reported rates: United States, 1984–2000 .............. 10 
 

Figure 3. Chlamydia — Rates by state: United States and outlying areas, 2000 ..... 11 
 

Figure 4. Chlamydia — Rates by region: United States, 1984–2000.............. 11 
 

Figure 5. Chlamydia — Rates by gender: United States, 1984–2000 ............. 12 
 

Figure 6. Chlamydia — Age- and gender-specific rates: United States, 2000 ....... 12 
 

Figure 7. Chlamydia — Positivity among 15-24 year old women tested in family
 

planning clinics by state, 2000 ................................... 13 
 

Figure 8. Chlamydia — Trends in positivity among 15-44 year old women tested
 

in family planning clinics by HHS regions, 1988–2000 ................ 13 
 

Gonorrhea 

Figure 9. Gonorrhea — Reported rates: United States, 1970–2000 and the
 

Healthy People year 2010 objective .............................. 18 
 

Figure 10. Gonorrhea — Rates by state: United States and outlying areas, 2000 ..... 18 
 

Figure 11. Gonorrhea — Rates by region: United States, 1981–2000 and the
 

Healthy People year 2010 objective .............................. 19 
 

Figure 12. Gonorrhea — Rates by gender: United States, 1981–2000 and the
 

Healthy People year 2010 objective .............................. 19 
 

Figure 13. Gonorrhea — Rates by race and ethnicity: United States, 1981–2000
 

and the Healthy People year 2010 objective ........................ 20 
 

Figure 14. Gonorrhea — Age- and gender-specific rates: United States, 2000 ....... 20 
 

Figure 15. Gonorrhea — Positivity among 15-24 year old women tested in family
 

planning clinics by state, 2000 ................................... 21 
 

Figure 16. Gonococcal Isolate Surveillance Project (GISP) — Location of participating clinics and regional laboratories: United States, 2000 ............ 21 
 

Figure 17. Gonococcal Isolate Surveillance Project (GISP) — Penicillin and
 

tetracycline resistance among GISP isolates, 2000 .................... 22 
 

Figure 18. Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria
 

gonorrhoeae isolates with decreased susceptibility or resistance to
 

ciprofloxacin, 1990–2000 ...................................... 22 
 

Figure 19. Gonococcal Isolate Surveillance Project (GISP) — Percent of men
 

with gonorrhea who had a previous gonorrhea infection, 1991–2000 ..... 23 
 

Syphilis 

Figure 20. Syphilis — Reported cases by stage of illness: United States,
 

1941–2000 ................................................. 28 
 

Figure 21. Primary and secondary syphilis — Reported rates: United States,
 

1970–2000 and the Healthy People year 2010 objective............... 28 
 

Figure 22. Primary and secondary syphilis — Rates by state: United States and
 

outlying areas, 2000 .......................................... 29 
 

ix 
Figure 23. Primary and secondary syphilis — Counties with rates above and 

counties with rates below the Healthy People year 2010 objective: 

United States, 2000 ........................................... 29 
 

Figure 24. Primary and secondary syphilis — Rates by region: United States, 

1981–2000 and the Healthy People year 2010 objective............... 30 
 

Figure 25. Primary and secondary syphilis — Rates by urban-rural category and 

geographic region, 2000 ....................................... 30 
 

Figure 26. Primary and secondary syphilis — Rates by gender: United States, 

1981–2000 and the Healthy People year 2010 objective............... 31 
 

Figure 27. Primary and secondary syphilis — Rates by race and ethnicity: United 

States, 1981–2000 and the Healthy People year 2010 objective ......... 31 
 

Figure 28. Primary and secondary syphilis — Age- and gender-specific rates: 

United States, 2000 ........................................... 32 
 

Figure 29. Congenital syphilis — Reported cases for infants <1 year of age 

and rates of primary and secondary syphilis among women: 

United States, 1970–2000 ...................................... 32 
 

Figure 30. Congenital syphilis — Rates for infants <1 year of age: United States, 

1981–2000 and the Healthy People year 2010 objective............... 33 
 

Other Sexually Transmitted Diseases 

Figure 31. Chancroid — Reported cases: United States, 1981–2000 .............. 36 
 

Figure 32. Genital herpes — Initial visits to physicians’ offices: United States, 

1966–2000 ................................................. 36 
 

Figure 33. Genital herpes simplex virus type 2 infections — Percent seroprevalence 

according to age in NHANES II (1976–1980) and NHANES III
 

(1988–1994) ................................................ 37 
 

Figure 34. Genital warts — Initial visits to physicians’ offices: United States, 

1966–2000 ................................................. 37 
 

Figure 35. Nonspecific urethritis — Initial visits to physicians’ offices by men: 

United States, 1966–2000 ...................................... 38 
 

Figure 36. Trichomonal and other vaginal infections — Initial visits to physicians’ 

offices: United States, 1966–2000 ................................ 38 
 

Additional Figures in the Special Focus Profiles 

STDs in Women and Infants 

Figure A. Chlamydia — Rates for women by state: United States and outlying
 

areas, 2000 ................................................. 45 
 

Figure B. Gonorrhea — Rates for women by state: United States and outlying
 

areas, 2000 ................................................. 45 
 

Figure C. Primary and secondary syphilis — Rates for women by state:
 

United States and outlying areas, 2000 ............................ 46 
 

Figure D. Congenital syphilis — Rates for infants <1 year of age by state:
 

United States and outlying areas, 2000 ............................ 46 
 

x 
Figure E. Congenital syphilis — Cases by prenatal care utilization: United States, 

1995-2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 

Figure F. Chlamydia — Positivity among 15-24 year old women tested in 

prenatal clinics by state, 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 

Figure G. Gonorrhea — Positivity among 15-24 year old women tested in 

prenatal clinics by state, 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 

Figure H. Ectopic pregnancy — Hospitalizations of women 15-44 years of age: 

United States, 1980-1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 

Figure I. Pelvic inflammatory disease — Hospitalizations of women 15-44 years 

of age: United States, 1980–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 

Figure J. Pelvic inflammatory disease — Initial visits to physicians’ offices by 

women 15-44 years of age: United States, 1980–2000 . . . . . . . . . . . . . . . . 49 

STDs in Adolescents and Young Adults 

Figure K. Chlamydia — Positivity among women tested in family planning clinics 

by age group: Region X, 1988–2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 

Figure L. Chlamydia — Prevalence among 16-24 year-old women entering the 

National Job Training Program by state of residence, 2000 . . . . . . . . . . . . . 54 

Figure M. Chlamydia — Positivity among 17-37 year-old women entering the 

U.S. Army by state of residence, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 

Figure N. Chlamydia — Positivity among 17-37 year-old men entering the 

U.S. Army by state of residence, 1999-2000 . . . . . . . . . . . . . . . . . . . . . . . . 55 

Figure O. Gonorrhea — Prevalence among 16-24 year-old women entering the 

National Job Training Program by state of residence, 2000 . . . . . . . . . . . . . 56 

Figure P. Gonorrhea — Positivity among 17-37 year-old men entering the 

U.S. Army by state of residence, 1999-2000 . . . . . . . . . . . . . . . . . . . . . . . . 56 

Figure Q. Gonorrhea — Age-specific rates among women 10-44 years of age: 

United States, 1981–2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 

Figure R. Gonorrhea — Age-specific rates among men 10-44 years of age: 

United States, 1981–2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 

Figure S. Primary and secondary syphilis — Age-specific rates among women 

10-44 years of age: United States, 1981–2000 . . . . . . . . . . . . . . . . . . . . . . 58 

Figure T.	 Primary and secondary syphilis — Age-specific rates among men 

10-44 years of age: United States, 1981–2000 . . . . . . . . . . . . . . . . . . . . . . 58 

STDs in Racial and Ethnic Minorities 

Figure U. Chlamydia — Positivity among women tested in family planning clinics 

by race and ethnicity: Region X, 1988–2000 . . . . . . . . . . . . . . . . . . . . . . . . 61 

Figure V. Chlamydia — Positivity among 15-30 year old women tested in 

Indian Health Service Clinics by IHS regions, 2000 . . . . . . . . . . . . . . . . . . . 61 

Figure W. Gonorrhea — Reported rates for 15-19 year old females by race 

and ethnicity: United States, 1981–2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 

Figure X. Gonorrhea — Reported rates for 15-19 year old males by race and 

ethnicity: United States, 1981–2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 

Figure Y. Primary and secondary syphilis — Reported rates for 15-19 year old 

females by race and ethnicity: United States, 1981–2000 . . . . . . . . . . . . . . 63 

xi 
Figure Z. Primary and secondary syphilis — Reported rates for 15-19 year old 

males by race and ethnicity: United States, 1981–2000 . . . . . . . . . . . . . . . . 63 

Figure AA. Congenital syphilis — Rates for infants <1 year of age by mother’s 

race and ethnicity: United States, 1991–2000 and the Healthy People 

year 2010 objective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 

STDs Among Men Who Have Sex with Men 

Figure BB.	 MSM Project — Median STD clinic test positivity for chlamydia, 

gonorrhea, HIV and syphilis prevalence among MSM, by race/ 

ethnicity, 2000. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 

Figure CC.	 MSM Project — Median STD clinic test positivity for chlamydia, 

gonorrhea, and syphilis prevalence among MSM, by self-reported 

HIV status, 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 

Figure DD.	 Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria 

gonorrhoeae isolates obtained from MSM for STD clinics in 14 cities, 

1998, 1999 and 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 

STDs in Persons Entering Corrections Facilities 

Figure EE. Syphilis serologic tests — Percent seroreactivity in women entering 

juvenile and adult corrections facilities, 2000. . . . . . . . . . . . . . . . . . . . . . . . 71 

Figure FF. Syphilis serologic tests — Percent seroreactivity in men entering juvenile 

and adult corrections facilities, 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 

Figure GG. Chlamydia — Positivity in women entering juvenile and adult corrections 

facilities, 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 

Figure HH. Chlamydia — Positivity in men entering juvenile and adult corrections 

facilities, 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 

Figure II. Gonorrhea — Positivity in women entering juvenile and adult corrections 

facilities, 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 

Figure JJ. Gonorrhea — Positivity in men entering juvenile and adult corrections 

facilities, 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 

STDs in the South 

Figure KK. South — Primary and secondary syphilis case rates by county, 2000 . . . . . 77 

Figure LL. South — Increases and decreases in cases of primary and secondary 

syphilis in 2000 compared with 1999 cases, by county . . . . . . . . . . . . . . . . 77 
 

Figure MM. South — Chlamydia case rates by county, 2000 . . . . . . . . . . . . . . . . . . . . . 78 
 

Figure NN. South — Gonorrhea case rates by county, 2000 . . . . . . . . . . . . . . . . . . . . . 78 
 

Appendix 

Figure A1. Chlamydia — National Electronic Telecommunications System for 

Surveillance (NETSS) transmission status by state, 2000 . . . . . . . . . . . . . . 134 

Figure A2. Gonorrhea — National Electronic Telecommunications System for 

Surveillance (NETSS) transmission status by state, 2000 . . . . . . . . . . . . . . 134 

Figure A3.	 Primary and secondary syphilis — National Electronic Telecommunications System for Surveillance (NETSS) transmission status 

by state, 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 

xii 
Tables in the National Profile 

National Summary Tables 

Table 1. Cases of sexually transmitted diseases reported by state health
 

departments and rates per 100,000 civilian population: United States,
 

1941–2000 ................................................. 79 
 

Table 2. Reported cases of sexually transmitted disease by gender and reporting
 

source: United States, 2000 ..................................... 81 
 

Chlamydia 

Table 3. Chlamydia — Reported cases and rates by state/area, ranked by rates:
 

United States and outlying areas, 2000 ............................ 82 
 

Table 4. Chlamydia — Reported cases and rates by state/area and region listed in
 

alphabetical order: United States and outlying areas, 1996–2000 ........ 83 
 

Table 5. Chlamydia — Women – Reported cases and rates by state/area listed in
 

alphabetical order: United States and outlying areas, 1996–2000 ........ 84 
 

Table 6. Chlamydia — Men – Reported cases and rates by state/area listed in
 

alphabetical order: United States and outlying areas, 1996–2000 ........ 85 
 

Table 7. Chlamydia — Reported cases and rates in selected cities of >200,000
 

population, ranked by rates: United States and outlying areas, 2000 ...... 86 
 

Table 8. Chlamydia — Reported cases and rates in selected cities of >200,000
 

population listed in alphabetical order: United States and outlying areas,
 

1996–2000 ................................................. 87 
 

Table 9. Chlamydia — Women – Reported cases and rates in selected cities of
 

>200,000 population listed in alphabetical order: United States and
 

outlying areas, 1996–2000 ..................................... 88 
 

Table 10. Chlamydia — Men – Reported cases and rates in selected cities of
 

>200,000 population listed in alphabetical order: United States and
 

outlying areas, 1996–2000 ..................................... 89 
 

Table 11A. Chlamydia — Reported cases by age, gender, and race/ethnicity: United
 

States, 1996–2000............................................ 90 
 

Table 11B. Chlamydia — Reported rates per 100,000 population by age, gender,
 

and race/ethnicity: United States, 1996–2000 ....................... 91 
 

Gonorrhea 

Table 12. Gonorrhea — Reported cases and rates by state/area, ranked by rates:
 

United States and outlying areas, 2000 ............................ 92 
 

Table 13. Gonorrhea — Reported cases and rates by state/area and region listed
 

in alphabetical order: United States and outlying areas, 1996–2000 ...... 93 
 

Table 14. Gonorrhea — Women – Reported cases and rates by state/area listed
 

in alphabetical order: United States and outlying areas, 1996–2000 ...... 94 
 

Table 15. Gonorrhea — Men – Reported cases and rates by state/area listed in
 

alphabetical order: United States and outlying areas, 1996–2000 ........ 95 
 

Table 16. Gonorrhea — Reported cases and rates in selected cities of >200,000
 

population, ranked by rates: United States and outlying areas, 2000 ...... 96 
 

xiii 
Table 17. Gonorrhea — Reported cases and rates in selected cities of >200,000 

population listed in alphabetical order: United States and outlying areas, 

1996–2000 ................................................. 97 
 

Table 18. Gonorrhea — Women – Reported cases and rates in selected cities of 

>200,000 population listed in alphabetical order: United States and 

outlying areas, 1996–2000 ..................................... 98 
 

Table 19. Gonorrhea — Men – Reported cases and rates in selected cities of 

>200,000 population listed in alphabetical order: United States and 

outlying areas, 1996–2000 ..................................... 99 
 

Table 20A. Gonorrhea — Reported cases by age, gender, and race/ethnicity: 

United States, 1996–2000 ..................................... 100 
 

Table 20B. Gonorrhea — Reported rates per 100,000 population by age, gender, 

and race/ethnicity: United States, 1996–2000 ...................... 101 
 

Syphilis 

Table 21. All stages of syphilis — Reported cases and rates by state/area listed in 

alphabetical order: United States and outlying areas, 1996–2000 ....... 102 
 

Table 22. All stages of syphilis — Reported cases and rates in selected cities of 

>200,000 population listed in alphabetical order: United States and 

outlying areas, 1996–2000 .................................... 103 
 

Table 23. Primary and secondary syphilis — Reported cases and rates by state/ 

area, ranked by rates: United States and outlying areas, 2000 .......... 104 
 

Table 24. Primary and secondary syphilis — Counties and independent cities 

ranked by number of reported cases: United States, 2000 ............. 105 
 

Table 25. Primary and secondary syphilis — Reported cases and rates by state/ 

area and region listed in alphabetical order: United States and outlying 

areas, 1996–2000 ........................................... 106 
 

Table 26. Primary and secondary syphilis — Women – Reported cases and rates 

by state/area listed in alphabetical order: United States and outlying 

areas, 1996–2000 ........................................... 107 
 

Table 27. Primary and secondary syphilis — Men – Reported cases and rates by 

state/area listed in alphabetical order: United States and outlying areas, 

1996–2000 ................................................ 108 
 

Table 28. Primary and secondary syphilis — Reported cases and rates in selected 

cities of >200,000 population, ranked by rates: United States and 

outlying areas, 2000 ......................................... 109 
 

Table 29. Primary and secondary syphilis — Reported cases and rates in selected 

cities of >200,000 population listed in alphabetical order: United States 

and outlying areas, 1996–2000 ................................. 110 
 

Table 30. Primary and secondary syphilis — Women – Reported cases and rates 

in selected cities of >200,000 population listed in alphabetical order: 

United States and outlying areas, 1996–2000 ...................... 111 
 

Table 31. Primary and secondary syphilis — Men – Reported cases and rates in 

selected cities of >200,000 population listed in alphabetical order: 

United States and outlying areas, 1996–2000 ...................... 112 
 

Table 32A. Primary and secondary syphilis — Reported cases by age, gender, and 

race/ethnicity: United States, 1996–2000.......................... 114 
 

xiv 
Table 32B. Primary and secondary syphilis — Reported rates per 100,000 population 

by age, gender, and race/ethnicity: United States, 1996–2000.......... 115 
 

Table 33. Early latent syphilis — Reported cases and rates by state/area listed in 

alphabetical order: United States and outlying areas, 1996–2000 ....... 116 
 

Table 34. Early latent syphilis — Reported cases and rates in selected cities of 

>200,000 population listed in alphabetical order: United States and 

outlying areas, 1996–2000 .................................... 117 
 

Table 35. Late and late latent syphilis — Reported cases and rates by state/ 

area listed in alphabetical order: United States and outlying areas, 

1996–2000 ................................................ 118 
 

Table 36. Late and late latent syphilis — Reported cases and rates in selected 

cities of >200,000 population listed in alphabetical order: United States 

and outlying areas, 1996–2000 ................................. 119 
 

Table 37. Congenital syphilis — Reported cases and rates in infants <1 year 

of age: United States (excluding outlying areas), 1963–2000 ........... 120 
 

Table 38. Congenital syphilis — Reported cases and rates in infants <1 year of age 

by state/area, ranked by rates: United States and outlying areas, 2000 . . . 121
 

Table 39. Congenital syphilis — Reported cases and rates in infants <1 year of age 

by state/area listed in alphabetical order: United States and outlying 

areas, 1996–2000 ........................................... 122 
 

Table 40. Congenital syphilis — Reported cases and rates in infants <1 year of age 

in selected cities of >200,000 population, ranked by rates: United States 

and outlying areas, 2000 ...................................... 123 
 

Table 41. Congenital syphilis — Reported cases and rates in infants <1 year of age 

in selected cities of >200,000 population listed in alphabetical order: 

United States and outlying areas, 1996–2000 ...................... 124 
 

Chancroid 

Table 42. Chancroid — Reported cases and rates by state/area listed in alphabetical order: United States and outlying areas, 1996–2000............ 125 
 

Table 43. Chancroid — Reported cases and rates in selected cities of >200,000 

population listed in alphabetical order: United States and outlying 

areas, 1996–2000 ........................................... 126 
 

Appendix 

Table A1. Healthy People 2010 Sexually Transmitted Diseases Objective Status .... 136 
 

xv 
Geographic Divisions of the United States 

West Midwest Northeast

South 

West Midwest South Northeast 

Alaska Illinois Alabama Connecticut 

Arizona Indiana Arkansas Maine 

California Iowa Delaware Massachusetts 

Colorado Kansas District of Columbia New Hampshire 

Hawaii Michigan Florida New Jersey 

Idaho Minnesota Georgia New York 

Montana Missouri Kentucky Pennsylvania 

Nevada Nebraska Louisiana Rhode Island 

New Mexico North Dakota Maryland Vermont 

Oregon Ohio Mississippi 

Utah South Dakota North Carolina 

Washington Wisconsin Oklahoma 

Wyoming South Carolina 

Tennessee 

Texas 

Virginia 

West Virginia 

xvi 
National Overview of Sexually Transmitted Diseases, 2000 

The logo on the cover of Sexually Transmitted Disease Surveillance, 2000 is a reminder of the 

multifaceted, national dimensions of the morbidity, mortality, and costs that result from sexually 

transmitted diseases (STDs) in the United States. It highlights the central role of STD prevention in 

improving health among women and infants and in promoting HIV prevention. Organized collaboration among interested, committed public and private organizations is the key to reducing STDs 

and their related health burdens in our population. As noted in the report of the Institute of Medicine, The Hidden Epidemic: Confronting Sexually Transmitted Diseases,1 surveillance is a key component of our efforts to prevent and control these diseases. 

This overview summarizes national surveillance data on the three diseases for which we have 

federally-funded control programs: chlamydia, gonorrhea, and syphilis. Several observations for 

2000 are worthy of note. 

Chlamydia 

In 2000, 702,093 cases of genital Chlamydia trachomatis infection were reported to CDC (Table 

1). This case count corresponds to a rate of 257.5 cases per 100,000 persons, an increase of 2.3% 

compared with the rate of 251.6 in 1999. Rates of reported chlamydial infection among women 

have been increasing annually since the late 1980s when public programs for screening and treatment of women were first established to avert pelvic inflammatory disease and related complications. Chlamydia screening and reporting are likely to expand further in response to the recently 

implemented Health Plan Employer Data and Information Set (HEDIS) measure for chlamydia 

screening of sexually active women 15 to 25 years of age who are provided medical care through 

managed care organizations.2 The increase in chlamydia case reports in 2000 most likely represents 

a continued increase in screening for this infection and also increased use of more sensitive 

chlamydia screening tests than used in prior years. 

In 2000, the overall reported rate of chlamydial infection in the U.S. among women (404.0 cases 

per 100,000 females) was approximately four times the reported rate among men (102.8 cases per 

100,000 males), reflecting the large number of women screened for this disease. However, with the 

increased availability of urine testing, men are increasingly being tested for chlamydial infection. 

From 1996 to 2000, the reported chlamydial infection rate in men increased by 71.9% (from 59.8 to 

102.8 cases per 100,000 males) compared with a 26.4% increase in women over this period (from 

319.5 to 404.0 cases per 100,000 females), reflecting increased screening among men (Tables 5 

and 6) . 

Data from multiple sources on prevalence of chlamydial infection in defined populations have 

been useful in monitoring disease burden and guiding chlamydia screening programs. In 2000, the 

median state-specific chlamydia test positivity among women 15 to 24 years who were screened at 

selected family planning clinics in all states, the District of Columbia, Puerto Rico, and the Virgin Islands was 5.2% (range, 2.3% to 15.8%) (Figure 7), and at selected prenatal clinics in 23 states and 

STD Surveillance 2000 Overview 1 
Puerto Rico, 5.9% (range, 2.2% to 14.5%) (Figure F). For economically-disadvantaged women 16 

to 24 years who entered the National Job Training Program in 2000, from 30 states and Puerto 

Rico, the median state-specific prevalence was 11.9% (range, 6.8% to 19.8%) (Figure L). For 

women 15 to 30 years screened at Indian Health Service (IHS) clinics in four IHS regions, the prevalence ranged from 3.9% to 9.9% (Figure V). For adolescent women entering juvenile detention centers in 24 U.S. counties, the median chlamydia positivity was 15.0% (range, 1.5% to 28.9%) (Figure 

GG). For male entrants to the U.S. Army who were screened in 1999 and 2000, the overall 

chlamydia prevalence was 4.7% (range, 1.0% to 11.1% by state of residence) (Figure N). For adolescent men entering juvenile detention centers in 30 counties, the median chlamydia positivity was 

6.6% (range, 0.9% to 13.0%) (Figure HH). Although these data on prevalence are not entirely comparable because of differences in the populations screened, in the performance characteristics of 

the screening tests, and variations in screening criteria, they provide important information on the 

continuing high burden of disease in the United States. 

In parts of the United States where large scale chlamydia screening programs have been instituted, prevalence of disease has declined substantially. During 1988-2000, among 15-to 

44-year-old women participating in the screening programs in Health and Human Services (HHS) 

Region X family planning clinics, chlamydia test positivity declined 59.2% (from 13.0% to 5.3%) 

(Figure 8). After adjusting trends in chlamydia positivity to account for changes in laboratory test 

methods and associated increases in test sensitivity, chlamydia test positivity decreased in four of 10 

HHS regions from 1999 to 2000, and increased in six regions. Although chlamydia positivity has 

declined in the past year in some regions, most likely due to the effectiveness of screening and treating women, continued expansion of screening programs to populations with higher prevalence of 

disease may have contributed to the increases in positivity seen in other regions. See the Appendix 

for the composition of the HHS regions. 

Gonorrhea 

Following a 73.9% decline in the reported rate of gonorrhea from 1975 (467.7) to 1997 (122.0), 

overall rates increased in 1998 (131.6) and have since remained essentially unchanged at the 1998 

rate (Table 1). The gonorrhea rate for 2000 (131.6 cases per 100,000 persons) remained essentially 

unchanged from 1999 (132.0 cases per 100,000 persons) and 1998 (131.6 per 100,000 persons) 

(Table 1). The 2000 rate for gonorrhea exceeds the Healthy People 2010 (HP2010) objective of 19 

cases per 100,000 persons. 

The gonorrhea rate in the U.S. among females in 2000 was similar to the rate in 1999 (128.3 and 

128.7 cases per 100,000 females, respectively) (Table 14). Gender differences in gonorrhea rates in 

2000 (female rate 128.3 per 100,000, male rate 134.6 per 100,000) were similar to the gender difference in rates observed in 1999 (Tables 14 and 15). In contrast to the 20 years prior to 1998, which 

generally exhibited decreasing age-specific rates for gonorrhea, for most 5-year age categories there 

was little change in the reported rates between 1999 and 2000. As with chlamydia, rates of gonorrhea in women are particularly high in 15- to 19-year-olds, and in men, are highest in the 20- to 

24-year age group. 

In 2000, new data on gonorrhea prevalence in defined populations were available from several 

sources. These new data showed continuing high burden of disease in adolescents and young 

adults in some parts of the United States. Among 15- to 24-year-old women attending selected family planning clinics in 34 states and the Virgin Islands, the median state-specific gonorrhea prevalence was 0.9 (range, 0.0 % to 4.5%) (Figure 15). For women in this age group attending selected 

2 Overview STD Surveillance 2000 
prenatal clinics in 15 states, the median prevalence was 0.9% (range, 0.0% to 3.7%) (Figure G). For 

16- to 24-year-old women entering the National Job Training Program in 21 states and Puerto Rico 

in 2000, the median gonorrhea prevalence was 3.5% (range, 0.9% to 8.5%) (Figure O). For adolescent women entering juvenile detention facilities, the median positivity for gonorrhea was 4.9% 

(range, 0.5% to 13.0%) (Figure II); the median positivity in adolescent men entering juvenile detention facilities was 2.4% (range, 0.6% to 4.2%) (Figure JJ). 

Antimicrobial resistance in Neisseria gonorrhoeae remains a continuing concern; the most recent 

threat has been the increase in fluoroquinolone resistance reported from several Asian countries. 

Ciprofloxacin is a fluoroquinolone antibiotic that has been recommended for treatment of gonorrhea by CDC; this oral medication is inexpensive and effectively treats gonorrhea with a single dose. 

Although only 0.4% of N. gonorrhoeae isolates tested through the Gonococcal Isolate Surveillance 

Project (GISP) in 2000 demonstrated resistance to ciprofloxacin, this is a substantial increase from 

1998, when only 0.1% of isolates were reported to be resistant. Of note, the proportion of GISP isolates from Honolulu that were resistant to ciprofloxacin remains high and was 14.3% in 2000. This 

trend reinforces the recommendation made by CDC in 2000 that fluoroquinolones not be used to 

treat gonorrhea acquired in Hawaii3

. In 2000, there was also a high proportion of GISP isolate resistant to ciprofloxacin (5.6%) in Orange County, California. See Appendix for a further description 

of GISP. 

Data on characteristics of patients in the GISP sample have been used to obtain information on 

the sexual orientation of male STD clinic patients with gonorrhea. In 2000, there was a continuing 

increase in the proportion of GISP isolates from men who have sex with men (MSM). In 2000, the 

proportion of GISP isolates from MSM increased to 13.9% compared to 13.1% in 1999. In 1988 

only 4.0% of isolates were from MSM. The proportional increase in MSM in GISP has corresponded 

to an absolute increase in gonorrhea cases among MSM at STD clinics in several large cities that 

participate in GISP. 

Syphilis 

The National Plan to Eliminate Syphilis from the United States was developed and announced by 

the Surgeon General in October 19994 in response to several factors, including the important role of 

syphilis in facilitating the transmission of HIV infection, the differential impact of syphilis on racial 

and ethnic minorities, and the recent decline in this disease. The 5,979 cases of primary and secondary (P&S) syphilis reported in 2000 were the fewest cases ever reported in the United States. 

However, the P&S syphilis rate of 2.2 per 100,000 persons (the lowest since national reporting began in 1941) remains substantially above the goal for syphilis elimination of 0.4 case per 100,000 

persons (about 1,000 cases per year)4 (Table 1), and the HP2010 goal of 0.2 per 100,000 persons. 

The number of P&S syphilis cases reported in 2000 was 9.6% lower than the 6,617 cases reported in 1999. However, this decline was substantially less than the reductions of approximately 

20% per year since the last major syphilis epidemic peaked in 1990. Although this smaller decline 

may partially reflect improved case finding and reporting, it also reflects the persistence of this disease in some populations and recent outbreaks in several geographic areas, including outbreaks 

among MSM. 

One factor that greatly facilitates syphilis elimination efforts is that this disease continues to be primarily reported only in specific areas of the country. In 2000, 2,520 (80.2%) of the 3,139 counties in 

the United States reported no cases of P&S syphilis (see Appendix for details on county coding). 

STD Surveillance 2000 Overview 3 
Half of all the P&S syphilis cases were reported from only 21 counties and one city (0.7% of total 

number of U.S. counties) (Table 24). However, the 2000 P&S syphilis rates were greater than the 

HP2010 objective in 595 counties (18.9% of the total number of U.S. counties). These 595 counties accounted for more than 99.5% of all reported P&S syphilis cases (5,952 out of 5,979 cases). 

Sixty-nine percent (412 out of 595) of these counties are located in the southern part of the United 

States. These data suggest that comprehensive syphilis prevention efforts focused in the South 

could markedly reduce the number of syphilis cases occurring in the United States. 

Between 1999 and 2000, the national rate of congenital syphilis decreased by 7.6%, from 14.5 to 

13.4 cases per 100,000 live births (Table 39). The continuing reduction in congenital syphilis rates, 

occurring since the early 1990s, reflects the substantial reduction in the rate of P&S syphilis among 

women over the same period. In 2000, approximately one half of the states and outlying areas had 

a reported rate of congenital syphilis that was greater than the HP2010 objective of 1.0 case per 

100,000 live births (Table 38). 

Although wide disparities exist in the reported rates of STDs among racial and ethnic groups, 

there has been a reduction in these differences for some diseases over the past five years. For example, the P&S syphilis rate reported for 2000 among African-Americans was 21 times the rate reported among whites, reflecting a substantial decline from 1996, when the rate among 

African-Americans was 50 times greater than that among whites (Table 32B). Although reporting biases likely magnify differences in reported rates by race and ethnicity, these factors continue to be 

risk markers among the U.S. population that correlate with other, more fundamental determinants 

of health status such as socioeconomic status and access to quality medical care. 

1Institute of Medicine. The Hidden Epidemic: Confronting Sexually Transmitted Diseases, Committee on 

Prevention and Control of Sexually Transmitted Diseases, National Academy Press, Washington, DC, 

1997. 

2National Committee for Quality Assurance (NCQA). HEDIS 2000: Technical Specifications, Washington, 

DC, 1999, pp. 68-70, 285-286. 

3Centers for Disease Control and Prevention. Fluoroquinolone-resistance in Neisseria gonorrhoeae, Hawaii, 

1999, and decreased susceptibility to azithromycin in N. Gonorrhoeae, Missouri, 1999. MMWR 

2000;49:833-837. 

4Division of STD Prevention. The National Plan to Eliminate Syphilis from the United States. National Center 

for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 1999. 

4 Overview STD Surveillance 2000 
National Profile 

The National Profile section contains figures showing trends and the distribution of sexually 

transmitted diseases (STDs) by age, gender, race/ethnicity, and location for the United States. 

Where relevant, the figures illustrate progress towards specific objectives for the nation published in 

U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding 

and Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government Printing Office, November 2000. 

* See the Appendix for a listing of the Healthy People 2010 objectives for the diseases addressed in this report. 

STD Surveillance 2000 National Profile 5 

Chlamydia 

Chlamydia trachomatis infections are the most commonly reported notifiable disease in the 

United States. They are among the most prevalent of all STDs and, since 1994, have comprised the 

largest proportion of all STDs reported to CDC (Table 1). In women, chlamydial infections, which 

are usually asymptomatic, may result in pelvic inflammatory disease (PID), which is a major cause 

of infertility, ectopic pregnancy, and chronic pelvic pain. Data from a randomized controlled trial of 

chlamydia screening in a managed care setting suggest that such screening programs can lead to a 

reduction in the incidence of PID by as much as 60%.1 As with other inflammatory STDs, 

chlamydial infection can facilitate the transmission of HIV infection. In addition, pregnant women 

infected with chlamydial infection can pass the infection to their infants during delivery, potentially 

resulting in neonatal ophthalmia and pneumonia. 

The increase in reported chlamydial infections during the 1990s reflects the expansion of 

chlamydia screening activities, use of increasingly sensitive diagnostic tests, an increased emphasis 

on case reporting from providers and laboratories, and improvements in the information systems 

for reporting. However, many women who are at risk for this infection are still not being tested, reflecting the lack of awareness among some health care providers and the limited resources available 

to support screening. Chlamydia screening and reporting are likely to expand further in response to 

the recently implemented Health Plan Employer Data and Information Set (HEDIS) measure for 

chlamydia screening of sexually active women 15 through 25 years of age who are provided medical care through managed care organizations.2 To better monitor trends in disease burden in defined populations during the expansion of chlamydia screening activities, data on chlamydia 

positivity among persons screened in a variety of settings are used; in most instances, test positivity 

serves as a reasonable approximation of prevalence.3 In parts of the United States where large scale 

chlamydia screening programs have been instituted, prevalence of the disease has declined 

substantially. 

•	 In 2000, for the first time, all 50 states and the District of Columbia had regulations 

requiring the reporting of chlamydia cases to CDC (Figure 1, Table 4). Prior to 

2000, the state of New York only reported cases identified in New York City. 

•	 In 2000, 702,093 chlamydial infections were reported to CDC from 50 states and 

the District of Columbia (Table 1). This case count corresponds to a rate of 257.5 

cases per 100,000 persons, an increase of 2.3% compared with the rate of 251.6 

in 1999. The reported number of chlamydial infections was approximately twice 

the number of reported cases of gonorrhea (358,995 gonorrhea cases were 

reported in 2000) (Table 1). 

•	 From 1987 through 2000, the reported rates of chlamydial infection increased 

from 50.8 to 257.5 cases per 100,000 persons (Figure 2, Table 1). The continuing 

increase in reported cases likely represents the further expansion of screening for 

this infection and also the development and use of more sensitive screening tests. 

•	 For the years 1996-2000, the chlamydia case rates in the Southern region of the 

United States (203.9, 230.1, 268.4, 286.0, 296.6 cases per 100,000 persons, 

STD Surveillance 2000 National Profile	 Chlamydia 7 
respectively) were higher than the rates in any other region of the country (Table 

4, Figure 4). The higher rates in this region likely reflect both an expansion of 

screening activities in the South and the high burden of disease in this region. 

Before 1996, reported chlamydia rates were highest in the West and Midwest, 

where substantial public resources had been committed for screening programs in 

family planning clinics. 

•	 In 2000, the overall reported rate of chlamydial infection among women in the 

U.S. (404.0 cases per 100,000 females) was four times higher than the reported 

rate among men (102.8 cases per 100,000 males), likely reflecting a greater 

number of women screened for this disease (Figure 5, Tables 5 and 6). The lower 

rates among men suggest that many of the sex partners of women with chlamydia 

are not diagnosed or reported. However, with the advent of the new, highly 

sensitive nucleic acid amplification tests that can be performed on urine, 

symptomatic and asymptomatic men are increasingly being diagnosed with 

chlamydial infection. From 1996 to 2000, the reported chlamydial infection rate 

in males increased by 71.9% (from 59.8 to 102.8 cases per 100,000 males) 

compared with a 26.4% increase in women over this period (from 319.5 to 404.0 

cases per 100,000 females) (Tables 5 and 6). 

•	 For women, the highest age-specific reported rates of chlamydia in 2000 

occurred among 15- to 19- year-olds (2,406.0 per 100,000 females) and 20- to 

24-year-olds (2,250.6 per 100,000 females). Age-specific reported rates among 

men, while substantially lower than the rates in women, were also highest in these 

same age groups (Figure 6). 

•	 In 2000, the reported rate of chlamydia among African-American females in the 

U.S. was nine times higher than the rate among white U.S. females (1,539.8 and 

174.3 per 100,000, respectively) (Table 11B). The chlamydia rate among U.S. 

African-American males was 13 times larger than that among white males (477.9 

and 36.0 per 100,000 respectively). 

•	 Chlamydia screening and prevalence monitoring activities were initiated in 

Health and Human Services (HHS) Region X in 1988 as a CDC-supported 

demonstration project. In 1993, chlamydia screening services for women were 

expanded to three additional HHS regions (III,VII, and VIII) and, in 1995, to the 

remaining HHS regions (I, II, IV, V, VI, and IX). In some regions, federally-funded 

chlamydia screening supplements local- and state-funded screening programs. 

•	 In 2000, the median chlamydia test positivity among 15- to 24-year-old women 

who were screened during visits to selected family planning clinics in all states and 

outlying areas was 5.2% (range, 2.3% to 15.8%) (Figure 7). In nearly all states 

chlamydia positivity was greater than the HP2010 objective of 3.0%.4 

•	 The effectiveness of large-scale screening programs in reducing chlamydia 

prevalence in women has been well documented in areas where this intervention 

has been in place for several years. For example, from 1988 to 2000, the 

screening programs in Health and Human Services Region X (Alaska, Idaho, 

Oregon, Washington) family planning clinics demonstrated a 59.2% decline in 

chlamydia positivity from 13.0% to 5.3% among 15- to 44-year-old women 

(Figure 8); chlamydia positivity was adjusted for changes in laboratory test 

methods and associated test sensitivity (see Appendix).5 

8 Chlamydia	 National Profile STD Surveillance 2000 
•	 After adjusting trends in chlamydia positivity to account for changes in laboratory 

test methods and associated increases in test sensitivity (see Appendix), 

chlamydia test positivity decreased in four of 10 HHS regions from 1999 to 2000 

and increased in six regions (Figure 8). Although chlamydia positivity has 

declined in the past year in some regions due to the effectiveness of screening and 

treatment of women, continued expansion of screening programs to populations 

with higher prevalence of disease may have contributed to increases in positivity 

in other regions. 

•	 Additional information on chlamydia screening programs for women of 

reproductive age and chlamydia among adolescents and minority populations 

can be found in the Special Focus Profiles section. 

1Scholes D, Stergachis A, Heidrich FE, Andrilla H, Holmes KK, Stamm WE. Prevention of pelvic inflammatory disease by screening for cervical chlamydial infection. N Engl J Med 1996;34(21): 1362-66. 

2National Committee for Quality Assurance (NCQA). HEDIS 2000: Technical Specifications, Washington, 

DC, 1999, pp. 68-70, 285-286. 

3Dicker LW, Mosure D, Levine W. Chlamydia positivity versus prevalence: what’s the difference? Sex 

Transm Dis 1998;25:251-3. 

4U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government Printing 

Office, November 2000. 

5Dicker LW, Mosure DJ, Levine WC, et al. Impact of switching laboratory tests on reported trends in 

Chlamydia trachomatis infections. Am J Epidemiol 2000;51:430-5. 

STD Surveillance 2000 National Profile	 Chlamydia 9 
Figure 1. Chlamydia — Number of states that require reporting of Chlamydia trachomatis 

infections: United States, 1987–2000 

No. of states 

50 

40 

30 

20 

10 

0 

1987 88 89 90 91 92 93 94 95 96 97 98 99 2000
 

Figure 2. Chlamydia — Reported rates: United States, 1984–2000 

Rate (per 100,000 population)
 

300
 

240 

180
 

120
 

60
 

0
 

1 9 8 4 8 6 8 8 9 0 9 2 9 4 9 6 9 8 2 0 0 0 
 

10 Chlamydia National Profile STD Surveillance 2000 
Figure 3. Chlamydia — Rates by state: United States and outlying areas, 2000 

227.0 

166.4 117.6 143.5 

214.3 169.7 

152.4 250.2 311.7 173.1 

168.3 266.0 VT 88.6 

222.1 227.5 208.6 

277.1 

220.7 NH 

MA 

94.1 

177.6 102.8 272.0 236.6 RI 265.6 287.8 295.8 228.2 245.9 203.6 

118.7 223.4 CT 

NJ 

231.7 

132.8 

DE 379.0 

274.8 287.4 MD 281.0 263.5 277.9 299.1 243.8 256.1 

Guam 321.1 

458.6 350.7 377.0 Rate per 100,000

population 

343.3 <=150 (n=9) 

414.7 408.2 150.1-300 (n=35) 

221.0 >300 (n=9) 

299.2 

Puerto Rico 69.3 Virgin Is. 116.1 

Note: The total rate of chlamydia for the United States and outlying areas (including Guam, Puerto 

Rico and Virgin Islands) was 254.8 per 100,000 population. For further information on 

chlamydia reporting, see the Appendix. 

Figure 4. Chlamydia — Rates by region: United States, 1984–2000 

Rate (per 100,000 population) 

300 

240 

180 

120 West 

Midwest 

Northeast 60 South 

0 

1984 86 88 90 92 94 96 98 2000 

STD Surveillance 2000 National Profile Chlamydia 11 
Figure 5. Chlamydia — Rates by gender: United States, 1984–2000 

Rate (per 100,000 population) 

Men 

Women 

0 

90 

180 

270 

360 

450 

1984 86 88 90 92 94 96 98 2000
 

Figure 6. Chlamydia — Age- and gender-specific rates: United States, 2000
 

Age 

Gender 

Total 

10-14 73.9 

15-19 1,348.5 

20-24 1,381.7 

25-29 516.9 

30-34 200.0 

35-39 83.8 

40-44 37.9 

45-54 15.6 

55-64 4.7 

65+ 2.9 

Total 256.9 

Note: Due to the methods used to impute missing age and sex data, numbers in this graph may 

not necessarily match those in Table 11B. See Appendix. 

12 Chlamydia National Profile STD Surveillance 2000
 
Figure 7. Chlamydia — Positivity among 15-24 year old women tested in family planning 

clinics by state, 2000 

6.3 

5.1 3.0 4.0 

3.9 5.5 

4.1 3.2 7.2 3.5 

4.7 4.5 VT 2.8 

7.3 

6.4 

4.6 

4.8 4.2 

4.0 4.3 

4.3 

7.4 5.2 

3.6 

6.3 

2.3 

6.3 

6.9 

NH 

MA 

RI 

CT 

NJ 

DE 

4.5 

5.4 

11.9 

5.1 

6.1 

5.2 

7.5 MD 6.2 4.9 DC 6.5 5.0 6.0 6.8 6.4 8.6 

15.8 7.9 7.1 Positivity (%) 

2.9 

9.3 

9.7 

5.0 

<4 

4.0-4.9 

>=5 

(n=8) 

(n=12) 

(n=33) 

5.1 

Puerto Rico 5.6 Virgin Is. 14.5 

Note: States reported chlamydia positivity data on at least 500 women aged 15-24 years screened 

during 2000 except for Minnesota and Rhode Island. 

SOURCE: Regional Infertility Prevention Programs; Office of Population Affairs; Local and State STD Control Programs; 

Centers for Disease Control and Prevention 

Figure 8.	 Chlamydia — Trends in positivity among 15-44 year old women tested in family 

planning clinics by HHS regions, 1988–2000 

REGION=I 

7.5 7.2 7.1 

5.7 6.2 6.2 6.4 

REGION=X 6.0 5.3 5.4 5.6 5.6 5.0 4.6 4.6 

6.7 13.0 

4.9 4.6 4.9 4.1 10.09.5 94 95 96 97 98 99 00 97 98 99 00 97 98 99 00 

8.0 

6.7 96 97 98 99 00 5.0 4.7 REGION=III 4.6 4.9 5.3 

4.1 3.9 3.9 

88 89 90 91 92 93 94 95 96 97 98 99 00 

7.4 

6.0 5.3 5.6 6.0 6.3 6.0 

REGION=IX 

94 95 96 97 98 99 00 

REGION=IV 5.9 6.3 6.2 5.1 5.2 

REGION=VI 

REGION=VII 10.1 9.5 8.9 8.6 96 97 98 99 00 

9.7 8.9 8.7 8.8 8.4 

5.4 5.3 5.5 97 98 99 00 4.9 4.7 

96 97 98 99 00 

96 97 98 99 00 

Note: Trends adjusted for changes in laboratory test method and associated increases in test 

sensitivity (see Appendix). No data on laboratory test method available for Region VII in 1995 

and Regions IV and V in 1996. See Appendix for definition of Health and Human Services 

(HHS) regions. 

SOURCE: Regional Infertility Prevention Programs; Office of Population Affairs; Local and State STD Control Programs; 

Centers for Disease Control and Prevention 

STD Surveillance 2000 National Profile	 Chlamydia 13 
Gonorrhea 

Infections due to Neisseria gonorrhoeae, like those resulting from Chlamydia trachomatis, are a 

major cause of pelvic inflammatory disease (PID) in the United States. Occurrence of PID can lead 

to serious outcomes such as tubal infertility, ectopic pregnancy, and chronic pelvic pain. In addition, 

epidemiologic and biologic studies provide strong evidence that gonococcal infections facilitate the 

transmission of HIV infection.1 

Following a 73.9% decline in the reported rate of gonorrhea from 1975 to 1997, in 1998 the gonorrhea rate increased and has remained essentially unchanged through 2000 (Table 1). Although 

increased screening (usually associated with simultaneous testing for chlamydial infection), use of 

more sensitive diagnostic tests, and improved reporting may account for a portion of the recent increase, true increases in disease in some populations and geographic areas also appear to have occurred.2 

As with chlamydial infection, reporting of gonorrhea cases to CDC is incomplete. In addition, reporting practices for gonococcal infections have likely been biased towards reporting of infections in 

persons of minority race or ethnicity who attend public STD clinics.2,3 As a result, for most areas, the 

number of gonorrhea cases reported to CDC are affected by many factors, only one of which is the 

occurrence of the infection within the population. For this reason, new data on gonorrhea prevalence in persons screened in a variety of different settings are useful in assessing disease burden in 

selected populations. 

•	 In 2000, 358,995 cases of gonorrhea were reported in the United States (Table 1). 

•	 Rates of reported gonococcal infections in the United States have been steady since 

1998 at about 132 cases per 100,000 population (131.6 in 2000, 132.0 in 1999, 

and 131.6 in 1998) (Table 13). In the period from 1975 to 1997, the national 

gonorrhea rate had been generally declining following the implementation of the 

national gonorrhea control program in the mid-1970s (Table 1). 

•	 In 2000, eight states and one outlying area reported gonorrhea rates below the 

Healthy People 2010 (HP2010) national objective of 19 cases per 100,000 

persons4 (Figure 10 and Table 12). 

•	 The gonorrhea rates in three of the four Census regions of the United States 

(Northeast, West, Midwest) increased between 1999 and 2000. However, the 

South had a 4.4% decrease in rates from 200.6 in 1999 to 191.8 in 2000. As in 

previous reporting years, the South had the highest reported gonorrhea rate in 

2000 among the four regions of the country (Figure 11, Table 13). 

•	 There was no meaningful change in the reported gonorrhea rate among women 

between 1999 and 2000 (128.7 and 128.3 cases per 100,000 females 

respectively). The gonorrhea rate in men remained the same with 134.7 and 

134.6 cases per 100,000 males in 1999 and 2000, respectively. State-specific 

reported gonorrhea rates for both men and women were higher than the HP2010 

STD Surveillance 2000 National Profile	 Gonorrhea 15 
objective of 19 cases per 100,000 persons in 42 states (Figure 12, Tables 14 and 

15). 

•	 The overall gonorrhea rate reported from selected large cities with populations 

over 200,000 persons was 234.9 cases per 100,000 persons in 2000. This rate is 

slightly higher than that reported for these cities in 1999 (232.5 cases per 100,000 

persons) (Table 17). All of these 64 cities had reported rates higher than the 

HP2010 objective of 19 cases per 100,000 persons (Table 16). 

•	 Changes in the reported 2000 gonorrhea rates, relative to those reported in1999, 

differed depending on racial/ethnic group. For example, the rates among 

Hispanics (78.1 in 2000 and 69.9 in 1999) and Asian/Pacific Islanders (30.0 in 

2000 and 20.9 in 1999) increased by 11.7% and 43.5% respectively between 

1999 and 2000. The 2000 rate among American Indians/Alaska Natives (114.4 

per 100,000) was 4.1% higher than the rate reported in 1999 (109.9 per 

100,000). Rates among non-Hispanic whites had a similar increase between 

1999 (26.9 per 100,000) and 2000 (28.0 per 100,000) while the rate among 

African-Americans decreased from 848.2 in 1999 to 827.0 in 2000 (Figure 13 

and Table 20B). The 2000 gonorrhea rates for all racial/ethnic groups were above 

the HP2010 objective of 19 per 100,000 population. In 2000, the reported 

gonorrhea rate among African-Americans was about 30 times greater than the 

rate for non-Hispanic whites. 

•	 Among women in 2000, 15- to 19-year-olds had the highest reported rate of 

gonorrhea (715.6 per 100,000), while among men, 20- to 24-year-olds had the 

highest rate (589.7 per 100,000) (Figure 14). 

•	 In 2000, the median state-specific gonorrhea test positivity among 15 to 24-year 

old women screened in selected family planning clinics in 34 states and the Virgin 

Islands was 0.9% (range, 0.0% to 4.5%) (Figure 15). 

•	 Antimicrobial resistance remains an important consideration in the treatment of 

gonorrhea.5,6 Overall, 24.7% of isolates collected in 2000 by the Gonococcal 

Isolate Surveillance Project (GISP) were resistant to penicillin, tetracycline, or 

both (Figure 17). 

•	 The proportion of GISP isolates demonstrating decreased susceptibility to 

ciprofloxacin, one of the currently recommended treatments for gonorrhea, 

decreased from a high of 1.3% in 1994 to 0.5% in 1996 and 1997, but since 1998 

has been increasing annually and was 1.6% in 2000 (Figure 18). 

•	 Resistance to ciprofloxacin was first identified in GISP in 1991. From 1991 to 

1998, fewer than 9 ciprofloxacin-resistant isolates were identified each year and 

such isolates were identified in only a few GISP clinics. In 2000, similar to 1999, 

19 (0.4%) ciprofloxacin-resistant GISP isolates were identified in 7 of the 25 GISP 

clinics. Notably, in Honolulu, the proportion of GISP isolates that were resistant to 

ciprofloxacin remained high and was 14.3% in 2000. This trend reinforces the 

recommendation made by CDC in 2000 that fluoroquinolones not be used to 

treat gonorrhea acquired in Hawaii.5 In 2000, there was also a high proportion of 

GISP isolates resistant to ciprofloxacin (5.6%) in Orange County, California. 

•	 In 2000, all GISP isolates were susceptible to ceftriaxone and to cefixime. The 

proportion of GISP isolates demonstrating decreased susceptibility to ceftriaxone 

or cefixime has remained very low over time. To date, no cephalosporin 

resistance has been identified in GISP. 

16 Gonorrhea	 National Profile STD Surveillance 2000 
• The proportion of GISP isolates demonstrating elevated minimum inhibitory 

concentrations (MICs) to azithromycin has been increasing since GISP began 

monitoring azithromycin susceptibility in 1992. In 1992, 0.9% of GISP isolates

had azithromycin MIC ≥0.5 μg/ml compared with 2.4% in 2000. In 1992, there

were no isolates with azithromycin MIC ≥1.0 μg/ml but in 2000, there were 19

such isolates.

• The percentage of men with gonorrhea who were reported to have had a 

gonorrhea infection in the previous year, as measured by the GISP, decreased 

from 21.5% in 1992 to 17.2% in 1999 but then rose to 23.6% in 2000 (Figure 19).

• Additional information about gonorrhea in racial and ethnic minority populations, 

adolescents, and other at risk populations can be found in the Special Focus 

Profiles section.

1Cohen MS, Hoffman IF, Royce RA, et al. Reduction of concentration of HIV-1 in semen after treatment of 

urethritis: implications for prevention of sexual transmission of HIV-1. Lancet 1997;349:1868-73.

2

Centers for Disease Control and Prevention. Gonorrhea – United States, 1998. MMWR 2000;49:538-42.

3

Fox KK, Whittington W, Levine WC, Moran JS, Zaidi AA, Nakashima AN. Gonorrhea in the United States,

1981-1996: demographic and geographic trends. Sex Transm Dis 1998;25(7):386-93.

4U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government Printing 

Office, November 2000.

5

Centers for Disease Control and Prevention. Fluoroquinolone-resistance in Neisseria gonorrhoeae, Hawaii,

1999, and decreased susceptibility to azithromycin in N. gonorrhoeae, Missouri, 1999. MMWR

2000;49:833-837.

6Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2000 Supplement: 

Gonococcal Isolate Surveillance Project (GISP) Annual Report 2000. Atlanta, GA: U.S. Department of 

Health and Human Services, Centers for Disease Control and Prevention, 2001 (in press).

STD Surveillance 2000 National Profile Gonorrhea 17
Figure 9.	 Gonorrhea — Reported rates: United States, 1970–2000 and the Healthy People 

year 2010 objective 

Rate (per 100,000 population)
 

500
 

400
 

300
 

200
 

100
 

0
 

Gonorrhea 

2010 Objective 

1970 73 76 79 82 85 88 91 94 97 2000
 

Note: The Healthy People 2010 (HP2010) objective for gonorrhea is 19.0 cases per 100,000 

population. 

Figure 10. Gonorrhea — Rates by state: United States and outlying areas, 2000
 

Rate per 100,000

population 

<20 

20-100 

>100 

VT 10.9 

NH 9.2 

MA 49.3 

RI 66.7 

CT 88.7 

NJ 88.8 

DE 230.2 

MD 190.2 

Guam 37.9 

Puerto Rico 13.5 Virgin Is. 21.3 

(n=9) 

(n=21) 

(n=23) 

276.0 

58.3 

86.4 142.7 

65.2 76.7 

150.8 

260.2 

40.7 

7.8 

170.4 109.8 

48.5 

105.3 88.4 

302.9 

7.2 

184.3 

66.2 

332.9 

162.4 

6.8 

92.1 85.8 

66.2 

110.5 

233.0 

11.5 

171.5 

125.9 

31.3 

113.4 

215.7 

37.8 

216.6 

164.2 

10.8 

148.0 

42.0 

35.7 

133.6 

11.1 

Note: The total rate of gonorrhea for the United States and outlying areas (including Guam, Puerto
 

Rico and Virgin Islands) was 129.9 per 100,000 population. The Healthy People year 2010
 

objective is 19.0 per 100,000 population.
 

18 Gonorrhea	 National Profile STD Surveillance 2000
 
Figure 11.	 Gonorrhea — Rates by region: United States, 1981–2000 and the Healthy 

People year 2010 objective 

Rate (per 100,000 population)
 

600
 

480
 

360
 

240
 

120
 

0
 

West 

Midwest 

Northeast 

South 

2010 Objective 

1981 83 85 87 89 91 93 95 97 99
 

Figure 12. Gonorrhea — Rates by gender: United States, 1981–2000 and the Healthy 

People year 2010 objective 

Rate (per 100,000 population)
 

600
 

480
 

360
 

240
 

120
 

0
 

Male 

Female 

2010 Objective 

1981 83 85 87 89 91 93 95 97 99
 

STD Surveillance 2000 National Profile	 Gonorrhea 19 
Figure 13. Gonorrhea — Rates by race and ethnicity: United States, 1981–2000 and the 

Healthy People year 2010 objective 

Rate (per 100,000 population) 

White 

Black 

Hispanic 

Asian/Pac Isl 

Nat Am/AK Nat 

2010 Objective 

0 

500 

1,000 

1,500 

2,000 

2,500 

1981 83 85 87 89 91 93 95 97 99 

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women

750 600 450 300 150 0 Age 0 150 300 450 600 750

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

8.3 10-14

327.9

589.7

362.2

210.6

140.4

92.6

49.5

18.6

5.0

134.7

53.3

715.6

656.7

252.1

112.5

60.3

29.3

9.1

1.8

0.9

128.4

Men Rate (per 100,000 population) Women 

750 600 450 300 150 0 Age 0 150 300 450 600 750 

Total 

65+ 

55-64 

45-54 

40-44 

35-39 

30-34 

25-29 

20-24 

15-19 

8.3 10-14

327.9 

589.7 

362.2 

210.6 

140.4 

92.6 

49.5 

18.6 

5.0 

134.7 

53.3 

715.6 

656.7 

252.1 

112.5 

60.3 

29.3 

9.1 

1.8 

0.9 

128.4 

Figure 14. Gonorrhea — Age- and gender-specific rates: United States, 2000 

Age 

Gender 

Total 

10-14 30.3 

15-19 516.3 

20-24 622.5 

25-29 306.9 

30-34 161.1 

35-39 100.1 

40-44 60.7 

45-54 28.9 

55-64 9.8 

65+ 2.6 

Total 131.4 

Note: Due to methods used to impute missing age and sex data, numbers in this graph may not 

necessarily match those in Table 20B. See Appendix. 

20 Gonorrhea National Profile STD Surveillance 2000 
Figure 15. Gonorrhea — Positivity among 15-24 year old women tested in family planning 

clinics by state, 2000 

0.6 

0.9 

1.7 

0.3 1.3 VT 0.1 

0.7 NH 0.1 

1.2 

1.1 

1.1 

0.4 

0.6 

1.8 0.9 1.1 

MA 

RI 

CT 0.7 

0.7 0.8 0.4 NJ 

DE 

1.7 

MD 0.9 DC 0.8 0.6 1.6 2.0 

4.5 2.0 1.7 Positivity (%) 

0.6 

1.5 

2.7 

0.9 

See * 

<1 

1.0-1.9 

>=2 

(n=18) 

(n=19) 

(n=11) 

(n=5) 

0.0 

Puerto Rico Virgin Is. 2.1 

*States reported gonorrhea positivity data on less than 500 women aged 15-24 years during 2000 

except for Alaska submitting data for June-December only and Ohio submitting data for 

August-December only. 

SOURCE: Regional Infertility Prevention Programs; Office of Population Affairs; Local and State STD Control Programs; 

Centers for Disease Control and Prevention 

Figure 16. Gonococcal Isolate Surveillance Project (GISP) — Location of participating 

clinics and regional laboratories: United States, 2000 

Seattle 

Portland 

Minneapolis 

Cleveland 

Philadelphia 

Chicago 

Cincinnati Baltimore San Francisco 

Denver Kansas City 

St. Louis 

Long Beach Ft. Bragg 

Orange Co. Phoenix Albuquerque San Diego 

Atlanta Birmingham 

Dallas New Orleans 

Anchorage 

Honolulu STD Clinics 

Laboratories Miami 

STD Surveillance 2000 National Profile Gonorrhea 21 
Figure 17. Gonococcal Isolate Surveillance Project (GISP) — Penicillin and tetracycline 

resistance among GISP isolates, 2000 

Susceptible 

PPNG 

TRNG 

PPNG/TRNG 

PenR 

TetR 

CMRNG 

75.2% 

1.6% 

5.9% 

0.6% 

3.8% 

5.1% 

7.7% 

Note: PPNG=penicillinase-producing N. gonorrhoeae; TRNG=plasmid-mediated tetracycline resistant 

N. gonorrhoeae; PPNG-TRNG=plasmid-mediated penicillin and tetracycline resistant N. 

gonorrhoeae; PenR=chromosomally mediated penicillin resistant N. gonorrhoeae; TetR= 

chromosomally mediated tetracycline resistant N. gonorrhoeae; CMRNG=chromosomally 

mediated penicillin and tetracycline resistant N. gonorrhoeae. 

Figure 18. Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria 

gonorrhoeae isolates with decreased susceptibility or resistance to 

ciprofloxacin, 1990–2000 

Percent 

2.0 

1.6 

1.2 

0.8 

0.4 

0.0 

Decreased susc. 

Resistance 

1990 91 92 93 94 95 96 97 98 99 2000
 

Note: Resistant isolates have ciprofloxacin MICs ≥ 1 μg/mL. Isolates with decreased susceptibility 

have ciprofloxacin MICs of 0.125 - 0.5 μg/mL. There were sixty-one (61) resistant isolates: 

one in 1991, one in 1993, two in 1994, eight in 1995, two in 1996, five in 1997, four in 1998, 

nineteen in 1999, and nineteen in 2000. Susceptibility to ciprofloxacin was first measured in 

GISP in 1990. 

22 Gonorrhea National Profile STD Surveillance 2000 
Figure 19. Gonococcal Isolate Surveillance Project (GISP) — Percent of men with 

gonorrhea who had a previous gonorrhea infection, 1991–2000 

Percent 

50
 

40
 

30
 

20
 

10
 

0 

Ever* 

Last 12 months** 

1991 92 93 94 95 96 97 98 99 2000
 

*Data first collected in 1991. 

**Data first collected in 1992. 

STD Surveillance 2000 National Profile Gonorrhea 23
 
Syphilis 

Syphilis, a genital ulcerative disease, facilitates the transmission of HIV and may be important in 

contributing to HIV transmission in those parts of the country, such as the South, where rates of both 

infections are high. Untreated early syphilis during pregnancy results in perinatal death in up to 40% 

of cases and, if acquired during the four years preceding pregnancy, may lead to infection of the fetus in over 70% of cases.1 

The rate of primary and secondary (P&S) syphilis reported in the United States is the lowest since 

reporting began in 1941. This unprecedented low rate and the concentration of the majority of 

syphilis cases in a small number of geographic areas have led to the development of the National 

Plan to Eliminate Syphilis from the United States, which was announced by Surgeon General David 

Satcher in October 1999.2 Collaboration with diverse organizations, public health professionals, the 

private medical community, and other partners working in STD and HIV is essential for the success 

of this effort.3 

The rate of P&S syphilis in the United States declined by 89.2% from 1990 through 2000. Nevertheless, syphilis remains an important problem in the South and in some urban areas in other regions of the country. Recently, outbreaks of syphilis among men who have sex with men (MSM) 

have been reported, possibly reflecting an increase in risky behavior in this population associated 

with the availability of highly active antiretroviral therapy for HIV infection.4,5 

•	 In 2000, P&S syphilis cases reported to CDC declined to 5,979 from 6,617 in 

1999, a decline of 9.6%. The number of P&S syphilis cases reported in 2000 is 

the lowest yearly number of cases ever reported (Table 1). The reported rate of 

P&S syphilis in the United States in 2000 (2.2 cases per 100,000 persons) was 

slightly below the rate reported in 1999 (2.4 cases per 100,000), although it is 

greater than the Healthy People 2010 (HP2010) objective of 0.2 case per 

100,000 persons (Figure 21, Table 1).6 

•	 Since 1990, the rate of early latent syphilis has exceeded the rate of P&S syphilis. 

There were approximately 0.9 case per 100,000 persons of early latent syphilis for 

every reported case of P&S syphilis in the five years preceding 1990 and 1.6 reported 

cases of early latent syphilis for every reported case of P&S syphilis in 2000 (Table 

1). 

•	 Since 1993, the rate of late and late latent syphilis has exceeded the rate of P&S 

syphilis. There were approximately 0.6 case per 100,000 persons of late and late 

latent syphilis for every reported case of P&S syphilis in the five years preceding 

1993 and 2.6 reported cases of late and late latent syphilis for every reported case 

of P&S syphilis in 2000 (Table 1). 

•	 In 2000, P&S syphilis rates in 14 states were less than or equal to the HP2010 

national objective of 0.2 case per 100,000 persons (Figure 22, Table 23). Fifteen 

states and two outlying areas reported five or fewer cases of P&S syphilis in 2000 

(Table 25). 

STD Surveillance 2000 National Profile	 Syphilis 25 
•	 In 2000, 2,520 (80.3%) of 3,139 counties in the United States reported no cases 

of P&S syphilis compared with 2,473 (78.8%) counties reporting no cases in 

1999. Of 619 counties reporting at least one case of P&S syphilis in 2000, 24 

(3.9%) reported rates at or below the HP2010 objective of 0.2 case per 100,000 

persons. Rates of P&S syphilis were above the HP2010 objective for 595 counties 

in 2000 (Figure 23). These 595 counties (18.9% of the total number of counties in 

the U.S.) accounted for more than 99.5% of the total P&S syphilis cases reported 

in 2000. 

•	 In 2000, 2,544 (81.0%) of the 3,139 United States counties reported P&S syphilis 

rates equal to or less than the HP2010 objective of 0.2 case per 100,000 persons. 

•	 In 2000, the largest numbers of cases of P&S syphilis were reported from 21 

counties and the city of Baltimore, MD (Table 24). These 22 areas account for half 

of the total number of P&S syphilis cases that were reported in the United States in 

2000. 

•	 In 2000, the reported rate of P&S syphilis among men (2.7 cases per 100,000 

males) was 1.5 times greater than the rate among women (1.8 cases per 100,000 

females). The overall male to female rate ratio has risen steadily since 1994 when 

it was 1.1 (Figure 26). 

•	 The P&S syphilis rate for 2000 in the South (3.8 cases per 100,000 persons) was 

higher than the rate reported in any other region of the country. The 2000 

reported rates in all regions were greater than the HP2010 objective of 0.2 case 

per 100,000 persons (Figure 24, Table 25). 

•	 Reported rates and case counts for P&S syphilis were calculated within each of 

the four geographic regions of the United States (Northeast, Midwest, South, and 

West) and for each of four categories representing the level of urbanization 

(urban, peri-urban, peri-rural, rural) (see Figure 25 and the Appendix for 

definitions of the categories). Reported P&S syphilis rates in the South were 

higher than the other regions of the country for all urbanization categories. Of the 

5,979 cases of P&S syphilis reported at the county level in 2000, 62.0% occurred 

in the South. 

•	 The overall rate of P&S syphilis reported in 2000 for selected large U.S. cities with 

populations of 200,000 persons or more (4.6 per 100,000 persons) was slightly 

less than the rate reported for these cities in 1999 (5.0 per 100,000 persons) 

(Table 29). However, rates exceeded the HP2010 objective of 0.2 case per 

100,000 persons in 57 (89.0%) of 64 large cities in the United States and outlying 

areas for which data were available (Table 28). 

•	 In 2000, the rate of P&S syphilis reported in African-Americans (12.8 cases per 

100,000 persons) was 21 times greater than the rate reported in whites (0.6 case 

per 100,000 persons). However, this differential was substantially less than that in 

1996, when the rate of P&S syphilis among African-Americans was 50 times 

greater than the rate reported among whites (Table 32B). 

•	 Between 1996 and 1999, the rates of P&S syphilis within racial and ethnic groups 

generally declined. Group-specific rates remained relatively constant between 

1999 and 2000, with the exception of the rate among African-Americans, which 

decreased from 15.0 to 12.8 cases per 100,000 persons during this period (Figure 

27, Table 32B). 

26 Syphilis	 National Profile STD Surveillance 2000 
•	 Between 1999 and 2000, the overall rate of congenital syphilis decreased by 

7.6% in the United States, from 14.5 to 13.4 cases per 100,000 live births (Figure 

29, Table 37). In addition, among the 21 states and outlying areas with five or 

more reported cases of congenital syphilis in 2000, 10 had rates that decreased 

since 1999. Three of these states and Puerto Rico had rate decreases of 30% or 

more between 1999 and 2000 (Table 39). 

•	 The continuing decrease in the rate of congenital syphilis (Figure 30) likely reflects 

the substantial reduction in the rate of P&S syphilis among women that has 

occurred in the last decade (Figure 29).7 During the period from 1991 through 

2000, the average yearly percentage decrease in the congenital syphilis rate was 

22% (Table 37). The average yearly percentage decrease in the rate of P&S 

syphilis reported among women for the years 1991 through 2000 was 21.0%. 

•	 In 2000, 27 states and one outlying area had reported rates of congenital syphilis 

that exceeded the HP2010 objective of 1.0 case per 100,000 live births (Table 

38). 

•	 Thirty-three (51.6%) of the 64 selected cities with populations of 200,000 persons 

or more had congenital syphilis rates greater than the HP2010 objective of 1.0 

case per 100,000 live births (Table 40). All of these cities had reported rates that 

were more than six times the HP2010 objective.7 

•	 Additional information on syphilis and congenital syphilis can be found in the 

Special Focus Profiles section. 

1Ingraham NR. The value of penicillin alone in the prevention and treatment of congenital syphilis. Acta 

Derm Venereol 31 (suppl 24): 60, 1951. 

2Division of STD Prevention. The National Plan to Eliminate Syphilis from the United States. National Center 

for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 1999. 

3Centers for Disease Control and Prevention. Primary and secondary syphilis – United States, 1999. MMWR 

2000;50:113-117. 

4Centers for Disease Control and Prevention. Resurgent bacterial sexually transmitted disease among men 

who have sex with men – King County, Washington, 1997-1999. MMWR 1999; 48:773-777. 

5Centers for Disease Control and Prevention. Outbreak of syphilis among men who have sex with men ­

Southern California, 2000. MMWR 2001; 50(7): 117-20. 

6U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government Printing 

Office, November 2000. 

7Centers for Disease Control and Prevention. Congenital Syphilis - United States, 2000. MMWR 

2001;50(27):573-77. 

STD Surveillance 2000 National Profile	 Syphilis 27 
Figure 20. Syphilis — Reported cases by stage of illness: United States, 1941–2000 

Thousands of cases 

600 

480 

360 

240 

120 

0 

P&S 

Early Latent 

Total Syphilis 

1941 46 51 56 61 66 71 76 81 86 91 96
 

Figure 21. Primary and secondary syphilis — Reported rates: United States, 1970–2000 

and the Healthy People year 2010 objective 

Rate (per 100,000 population)
 

25
 

20
 

15
 

10
 

5
 

0
 

P&S Syphilis 

2010 Objective 

1970 73 76 79 82 85 88 91 94 97 2000
 

Note: The Healthy People 2010 (HP2010) objective for primary and secondary syphilis is 0.2 

case per 100,000 population. 

28 Syphilis National Profile STD Surveillance 2000 
Figure 22. Primary and secondary syphilis — Rates by state: United States and outlying 

areas, 2000 

1.1 

0.0 0.0 0.1 

0.4 0.3 

0.1 0.0 0.9 0.7 

0.2 3.3 VT 0.0 

0.3 0.1 0.4 

0.6 

0.6 NH 

MA 

0.2 

1.1 0.1 3.4 5.9 RI 0.4 1.0 0.3 0.2 0.5 2.1 

0.2 1.8 CT 

NJ 

0.5 

0.9 

DE 1.2 

9.7 6.3 MD 5.8 4.0 3.5 0.9 4.1 5.9 

Guam 0.6 

4.9 2.8 5.2 Rate per 100,000

population 

2.0 <=.2 (n=14) 

0.0 4.8 .21-4 (n=29) 

2.7 >4 (n=10) 

0.2 

Puerto Rico 4.5 Virgin Is. 2.7 

Note: The total rate of primary and secondary syphilis for the United States and outlying areas 

(including Guam, Puerto Rico and Virgin Islands) was 2.2 per 100,000 population. The Healthy 

People year 2010 objective is 0.2 per 100,000 population. 

Figure 23. Primary and secondary syphilis — Counties with rates above and counties with 

rates below the Healthy People year 2010 objective: United States, 2000 

Rate per 100,000

Population 

<=0.2 (n=2,544) 

>0.2 (n=595) 

STD Surveillance 2000 National Profile Syphilis 29 
Figure 24. Primary and secondary syphilis — Rates by region: United States, 1981–2000 

and the Healthy People year 2010 objective 

Rate (per 100,000 population) 

West 

Midwest 

Northeast 

South 

2010 Objective 

0 

10 

20 

30 

40 

50 

1981 83 85 87 89 91 93 95 97 99
 

Figure 25. Primary and secondary syphilis — Rates by urban-rural category and
 

geographic region, 2000
 

Rate (per 100,000 population) 

Urban 

Peri-urban 

Peri-rural 

Rural 

0.0 

1.2 

2.4 

3.6 

4.8 

6.0 

U.S. West Midwest Northeast South 

Note: See Appendix for definitions and source of urban-to-rural categories. 

30 Syphilis National Profile STD Surveillance 2000
 
Figure 26. Primary and secondary syphilis — Rates by gender: United States, 1981–2000 

and the Healthy People year 2010 objective 

Rate (per 100,000 population) 

25 

20 

15 

10 

5 

0 

Male 

Female 

2010 Objective 

1981 83 85 87 89 91 93 95 97 99
 

Figure 27. Primary and secondary syphilis — Rates by race and ethnicity: United States, 

1981–2000 and the Healthy People year 2010 objective 

Rate (per 100,000 population)
 

150
 

120
 

90
 

60
 

30
 

0
 

White 

Black 

Hispanic 

Asian/Pac Isl 

Nat Am/AK Nat 

2010 Objective 

1981 83 85 87 89 91 93 95 97 99
 

STD Surveillance 2000 National Profile Syphilis 31 
Congenital

Syphilis

Figure 28. Primary and secondary syphilis — Age- and gender-specific rates: United 

States, 2000 

Men Rate (per 100,000 population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population) Women 

7.5 6.0 4.5 3.0 1.5 0.0 Age 0.0 1.5 3.0 4.5 6.0 7.5 

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0

1.6

4.6

5.8

5.7

5.4

4.6

3.0

1.4

0.5

2.6

0.0 

1.6 

4.6 

5.8 

5.7 

5.4 

4.6 

3.0 

1.4 

0.5 

2.6 

Age 

Gender 

Total 

10-14 0.1 

15-19 2.3 

20-24 4.9 

25-29 4.9 

30-34 4.9 

35-39 4.5 

40-44 3.5 

45-54 2.0 

55-64 0.8 

65+ 0.2 

Total 2.2 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

45-54 

55-64 

65+ 

Total 

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2

3.1

5.2

4.1

4.1

3.5

2.5

1.0

0.2

0.0

1.8

0.2 

3.1 

5.2 

4.1 

4.1 

3.5 

2.5 

1.0 

0.2 

0.0 

1.8 

Figure 29. Congenital syphilis — Reported cases for infants <1 year of age and rates of 

primary and secondary syphilis among women: United States, 1970–2000 

P&S rate (per 100,000 population) CS cases (in thousands) 

20 

16 

12 

8 

4 

0 

Kaufman Criteria 

CDC Surveillance Definition 

P&S Syphilis 

7.5 

6.0 

4.5 

3.0 

1.5 

0.0 

1970 75 80 85 90 95 2000 

Note: The surveillance case definition for congenital syphilis changed in 1988 (see Appendix). 

Case counts for congenital syphilis shown in this graph correspond to those listed in 

Table 37. 

32 Syphilis National Profile STD Surveillance 2000 
Figure 30. Congenital syphilis — Rates for infants <1 year of age: United States, 

1981–2000 and the Healthy People year 2010 objective 

Rate (per 100,000 live births) 

125
 

100
 

75
 

50
 

25
 

0
 

Cong. Syphilis 

2010 Objective 

1981 83 85 87 89 91 93 95 97 99
 

Note: The Healthy People 2010 (HP2010) objective for primary and secondary syphilis is 0.2 

case per 100,000 population.The surveillance case definition for congenital syphilis 

changed in 1988 (see Appendix). 

STD Surveillance 2000 National Profile Syphilis 33
 
Other Sexually Transmitted Diseases 

Since 1987, reported cases of chancroid have declined steadily (Table 42, Figure 31). In 2000, a 

total of 78 cases of chancroid were reported in the United States. Only twelve states and two outlying areas reported one or more cases of chancroid in 2000 and three of these states (New York, 

South Carolina and Texas) accounted for nearly 70.5% of the 78 reported cases in the U.S. Although the decline in reported chancroid cases most likely reflects a decline in the incidence of this 

disease, these data should be interpreted with caution in view of the fact that Haemophilus ducreyi, 

the causative organism of chancroid, is difficult to culture and, as a result, this condition may be substantially underdiagnosed.1,2 

Comprehensive surveillance data for genital herpes simplex virus (HSV), genital warts, human 

papillomavirus, non-gonococcal urethritis, and trichomoniasis are not available. Ongoing trend 

data are limited to estimates of the office visits in physicians’ office practices provided by the National Disease and Therapeutic Index (NDTI) (Figures 32 and 34-36). 

Serious consequences of genital herpes simplex virus infection include lifelong recurrent episodes 

of painful genital lesions, increased likelihood of HIV transmission and acquisition, and, for women 

who acquire genital herpes in pregnancy, potentially fatal neonatal infection.3 Data on genital herpes simplex virus type 2 (HSV-2) seroprevalence among the non-institutionalized U.S. population 

are available from the National Health and Nutrition Examination Survey (NHANES). In NHANES 

III (1988-1994), HSV-2 seroprevalence among persons at least 12 years of age was 21.9%, a prevalence which was 30% higher than the age-adjusted HSV-2 seroprevalence from NHANES II 

(1976-1980). Statistically significant increases in seroprevalence were concentrated in three of the 

youngest age groups which include persons aged 12 to 39 years (Figure 33).4 

For data on PID, see the Special Focus Profile on Women and Infants. 

1Schulte JM, Martich FA, Schmid GP. Chancroid in the United States, 1981-1990: Evidence for 

underreporting of cases. MMWR 1992;41(no. SS-3):57-61. 

2Mertz KJ, Trees D, Levine WC, et al. Etiology of genital ulcers and prevalence of human immunodeficiency 

virus coinfection in 10 US cities. Infect Dis 1998;178:1795-8. 

3Handsfield HH, Stone KM, Wasserheit JN. Prevention agenda for genital herpes. Sex Transm Dis 1999; 

26:228-231. 

4Fleming DT, McQuillan GM, Johnson RE, et al. Herpes simplex virus type 2 in the United States, 1976 to 

1994. N Engl J Med 1997;337:1105-11. 

STD Surveillance 2000 National Profile Other Sexually Transmitted Diseases 35 
Figure 31. Chancroid — Reported cases: United States, 1981–2000 

Cases (in thousands) 

5 

4 

3 

2 

1 

0 

1981 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 2000 

Figure 32. Genital herpes — Initial visits to physicians’ offices: United States, 1966–2000 

Visits (in thousands) 

250 

200 

150 

100 

50 

0 

1 9 6 6 6 9 7 2 7 5 7 8 8 1 8 4 8 7 9 0 9 3 9 6 9 9 
 

Note: See Appendix.
 

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
 

36 Other Sexually Transmitted Diseases National Profile STD Surveillance 2000 
Figure 33. Genital herpes simplex virus type 2 infections — Percent seroprevalence 

according to age in NHANES* II (1976-1980) and NHANES III (1988-1994) 

Percent 

NHANES II 

NHANES III 

0 

8 

16 

24 

32 

40 

12-19 20-29 30-39 40-49 50-59 60-69 70+ 

Age Group 

Note: Bars indicate 95% confidence intervals. 

*National Health and Nutrition Examination Survey 

Figure 34. Genital warts — Initial visits to physicians’ offices: United States, 1966–2000 

Visits (in thousands) 

0 

80 

160 

240 

320 

400 

1966 69 72 75 78 81 84 87 90 93 96 99 

Note: See Appendix.
 

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
 

STD Surveillance 2000 National Profile Other Sexually Transmitted Diseases 37 
Figure 35. Nonspecific urethritis — Initial visits to physicians’ offices by men: 

United States, 1966–2000 

Visits (in thousands) 

400 

320 

240 

160 

80 

0 

1 9 6 6 6 9 7 2 7 5 7 8 8 1 8 4 8 7 9 0 9 3 9 6 9 9 
 

Note: See Appendix.
 

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
 

Figure 36. Trichomonal and other vaginal infections — Initial visits to physicians’ offices: 

United States, 1966–2000 

Visits (in thousands) 

4,500 

3,600 

2,700 

1,800 

900 

0 

Trichomonal 

Other Vaginitis 

1966 69 72 75 78 81 84 87 90 93 96 99
 

Note: See Appendix.
 

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
 

38 Other Sexually Transmitted Diseases National Profile STD Surveillance 2000 
Special Focus Profiles 

The Special Focus Profiles section highlights trends and distribution of sexually transmitted 

diseases (STDs) in populations of particular interest for STD and HIV prevention programs in state 

and local health departments. These populations are most vulnerable to STDs and their consequences: women and infants; adolescents and young adults; minorities; men who have sex with 

men (MSM); persons entering corrections facilities; and populations in the southern United States. 

The Special Focus Profiles refer to figures located in disease-specific sections in the National 

Profile. In addition, there are figures (Figures A-NN) that highlight specific points made in the text. 

STD Surveillance 2000 Special Focus Profiles 39 

STDs in Women and Infants
 

Public Health Impact 

Women and infants disproportionately bear the long term consequences of STDs. Women infected with Neisseria gonorrhoeae or Chlamydia trachomatis can develop pelvic inflammatory disease (PID), which, in turn, may lead to adverse effects on the reproductive system such as ectopic 

pregnancy and tubal factor infertility. If not adequately treated, 20% to 40% of women infected with 

chlamydia1 and 10% to 40% of women infected with gonorrhea2 may develop PID. Among women 

with PID, scarring sequelae will cause involuntary infertility in 20%, ectopic pregnancy in 9%, and 

chronic pelvic pain in 18%.3 Approximately 70% of chlamydial infections and 50% of gonococcal 

infections in women are asymptomatic.4-6 These infections are detected primarily through screening 

programs. The vague symptoms associated with chlamydial and gonococcal PID cause 85% of 

women to delay seeking medical care, thereby increasing the risk of infertility and ectopic pregnancy.7 Data from a randomized controlled trial of chlamydia screening in a managed care setting 

suggest that such screening programs can reduce the incidence of PID by as much as 60%.8 

Gonorrhea and chlamydia can also result in adverse outcomes of pregnancy, including neonatal 

ophthalmia and, in the case of chlamydia, neonatal pneumonia. Although topical prophylaxis at 

delivery is effective for prevention of ophthalmia neonatorum, prevention of neonatal pneumonia 

requires antenatal detection and treatment. 

Genital infections with human papillomavirus (HPV) in women are a major concern because persistent infection with specific types (e.g., types 16, 18, 31, 33, 35, and 45), are causally related to 

cervical cancer; these types also cause Pap smear abnormalities. Other types (e.g., types 6 and 11) 

cause genital warts, Pap smear abnormalities and, rarely, recurrent respiratory papillomatosis in infants born to infected mothers.9 

When a woman has a syphilis infection during pregnancy, she may transmit the infection to the 

fetus in utero. This may result in fetal death or an infant born with physical and mental developmental disabilities. Most cases of congenital syphilis are preventable if women are screened for syphilis 

and treated early during prenatal care.10 

Observations 

•	 Between 1999 and 2000, the reported case rate of chlamydial infections in 

women increased slightly from 400.8 to 404.0 per 100,000 females (Figure 5, 

Table 5). Chlamydia rates exceed gonorrhea rates among women in all states 

(Figures A and B, Tables 5 and 14). 

•	 In 2000, the median state-specific chlamydia test positivity among 15- to 24­

year-old women screened in selected prenatal clinics in 23 states and Puerto Rico 

was 5.9% (range, 2.2% to 14.5%) (Figure F). 

STD Surveillance 2000	 Special Focus Profiles STDs in Women and Infants 41 
•	 Gonorrhea rates among women were higher than the overall HP 2010 objective 

of 19.0 cases per 100,000 persons11 in 42 states and two outlying areas in 2000 

(Figure B, Table 14). As in previous years, the highest rates of gonorrhea among 

women in 2000 occurred in the South (Figure B). 

•	 Like chlamydia, gonorrhea is often asymptomatic in women and can only be 

identified through screening. Large-scale screening programs for gonorrhea in 

women began in the late 1970s. After an initial increase in cases detected through 

screening, gonorrhea rates for both women and men declined steadily 

throughout the 1980s and early 1990s (Figure 12, Tables 14 and 15). The 

gonorrhea rate for women in 2000 (128.3 per 100,000 females) was similar to the 

1999 rate of 128.7 cases per 100,000 females. The gonorrhea rate among men in 

2000 (134.6 cases per 100,000 males) was also similar to the 1999 rate of 134.7 

cases per 100,000 males (Table 15). Men with gonorrhea are usually 

symptomatic and may seek care; therefore, trends in men may be a relatively 

good indicator of trends in incidence of disease. As with chlamydia, trends in 

reported gonorrhea rates among women are more likely to reflect screening 

practices as well as the actual burden of disease. 

•	 In 2000, the median state-specific gonorrhea test positivity among 15- to 24-yearold women screened in selected prenatal clinics in 15 states was 0.9% (range, 

0.0% to 3.7%) (Figure G). 

•	 The HP2010 objective for primary and secondary (P&S) syphilis is 0.2 case per 

100,000 persons. Primary and secondary syphilis rates for women exceeded the 

HP2010 objective in 32 states and two outlying areas (Table 26). For congenital 

syphilis, the HP2010 objective is 1.0 case per 100,000 live births. Twenty-seven 

states and one outlying area had reported rates higher than this objective in 2000 

(Figure D, Table 38). 

•	 The rate of congenital syphilis closely follows the trend of P&S syphilis in women 

(Figure 29). Peaks in congenital syphilis usually occur one year after peaks in P&S 

syphilis in women. The congenital syphilis rate peaked in 1991 at 107.3 cases per 

100,000 live births and has declined by 87.5% to 13.4 cases per 100,000 live 

births in 2000 (Figure 30, Table 37). The rate of P&S syphilis in women peaked at 

17.3 cases per 100,000 females in 1990 and declined 89.6% to 1.8 cases per 

100,000 females in 2000 (Figure 29). During 1991-2000, the average yearly 

percentage decrease in the rate of congenital syphilis was 22.0% (Table 37), while 

the average yearly decline in the rate of P&S syphilis reported among women 

during this period was 21.0%. 

•	 The 2000 reported rate of congenital syphilis for the United States is now well 

above the HP2010 objective of 1.0 case per 100,000 live births. This objective is 

many times greater than the rate of congenital syphilis of most industrialized 

countries where syphilis and congenital syphilis have nearly been eliminated.12 

•	 While most cases of congenital syphilis occur in infants whose mothers have had 

some prenatal care (Figure E), late or limited prenatal care has been associated 

with congenital syphilis. Lack of health care provider adherence to congenital 

syphilis screening recommendations also may result in congenital syphilis.13 

•	 Accurate estimates of pelvic inflammatory disease (PID) and tubal factor infertility 

from gonococcal and chlamydial infections are difficult to obtain. Definitive 

diagnosis of these conditions can be complex, requiring for example, laparoscopy 

42 STDs in Women and Infants Special Focus Profiles	 STD Surveillance 2000 
or laparotomy, while tubal patency studies may be needed to accurately 

document these conditions. Most cases of PID are treated on the basis of 

interpretations of clinical findings, which vary between individual practitioners. In 

addition, the settings in which care is provided can vary considerably over time. 

For example, women with PID who would have been hospitalized in the 1980s 

may be treated in outpatient facilities during the 1990s. Trends in hospitalized 

PID have declined steadily throughout the 1980s and early 1990s but have 

remained relatively constant from 1995 through 1999 (Figure I). These trends 

may be more reflective of changes in the etiologic spectrum (with increasing 

proportions of more indolent chlamydial infection) and clinical management of 

PID (from inpatient to outpatient) rather than true trends in disease.14 

•	 The reported number of initial visits to physicians’ offices for PID through the 

National Disease and Therapeutic Index (NDTI) has generally declined from 

1993 through 2000. The reported number of visits in 2000 was slightly lower than 

the number of initial visits reported in 1999 (Figure J). In 1999, an estimated 

268,018 cases of PID were diagnosed in emergency departments among women 

15 to 44 years of age (National Hospital Ambulatory Medical Care Survey, 

NCHS). This estimated number has an approximate relative standard error of 

17.5%. 

•	 Evidence suggests that health care practices associated with ectopic pregnancy 

also changed in the late 1980s and early 1990s. Before that time, treatment of 

ectopic pregnancy usually required admission to a hospital. Hospitalization 

statistics were therefore useful for monitoring trends in ectopic pregnancy. 

Beginning in 1989, hospitalizations for ectopic pregnancy began to decline. The 

number of reported hospitalizations for ectopic pregnancy decreased in 1999 

relative to the number reported in 1998 (Figure H). Data from outpatient care 

surveys suggest that nearly half of all ectopic pregnancies are treated on an 

outpatient basis.15 

1Stamm WE, Guinan ME, Johnson C. Effect of treatment regimens for Neisseria gonorrhoeae on simultaneous infections with Chlamydia trachomatis. N Engl J Med 1984;310:545-9. 

2Platt R, Rice PA, McCormack WM. Risk of acquiring gonorrhea and prevalence of abnormal adnexal findings among women recently exposed to gonorrhea. JAMA 1983;250:3205-9. 

3Westrom L, Joesoef R, Reynolds G, et al. Pelvic inflammatory disease and fertility: a cohort study of 1,844 

women with laparoscopically verified disease and 657 control women with normal laparoscopy. Sex 

Transm Dis 1992;9:185-92. 

4Hook EW III, Handsfield HH. Gonococcal infections in the adult. In: Holmes KK, Mardh PA, Sparling PF, et 

al, eds. Sexually Transmitted Diseases, 2nd edition. New York City: McGraw-Hill, Inc, 1990:149-65. 

5Stamm WE, Holmes KK. Chlamydia trachomatis infections in the adult. In: Holmes KK, Mardh PA, Sparling 

PF, et al, eds. Sexually Transmitted Diseases, 2nd edition. New York City: McGraw-Hill, Inc, 1990:181-93. 

6Zimmerman HL, Potterat JJ, Dukes RL, et al. Epidemiologic differences between chlamydia and gonorrhea. 

Am J Public Health 1990;80:1338-42. 

7Hillis SD, Joesoef R, Marchbanks PA, et al. Delayed care of pelvic inflammatory disease as a risk factor for 

impaired fertility. Am J Obstet Gynecol 1993;168:1503-9. 

STD Surveillance 2000	 Special Focus Profiles STDs in Women and Infants 43 
8Scholes D, Stergachis A, Heidrich FE, Andrilla H, Holmes KK, Stamm WE. Prevention of pelvic inflammatory disease by screening for cervical chlamydial infection. N Engl J Med 1996;34(21):1362-6. 

9Division of STD Prevention. Prevention of Genital HPV Infection and Sequelae: Report of an External Consultants’ Meeting. National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, December 1999. 

10Centers for Disease Control. Guidelines for prevention and control of congenital syphilis. MMWR 

1988;37(No.S-1). 

11U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government Printing 

Office, November 2000. 

12Division of STD/HIV Prevention. Healthy People 2000: National Health Promotion and Disease Objectives. 

Progress Review: Sexually Transmitted Diseases, October 26, 1994. 

13Centers for Disease Control and Prevention. Congenital syphilis - United States, 2000. MMWR 

2001;50:573-77. 

14Rolfs RT, Galaid EI, Zaidi AA. Pelvic inflammatory disease: trends in hospitalization and office visits, 1979 

through 1988. Am J Obstet Gynecol 1992;166:983-90. 

15Centers for Disease Control and Prevention. Ectopic pregnancy in the United States, 1990-1992. MMWR 

1995;44:46-8. 

44 STDs in Women and Infants Special Focus Profiles STD Surveillance 2000 
Figure A. Chlamydia — Rates for women by state: United States and outlying areas, 2000 

331.1 

247.1 178.1 208.2 

309.3 241.7 

228.8 351.0 462.6 285.7 

279.5 412.8 VT 143.2 

351.7 354.5 304.3 

431.7 

343.4 NH 

MA 

145.7 

264.4 150.3 407.6 358.4 RI 382.7 435.7 427.7 368.7 408.9 317.4 

191.1 369.2 CT 

NJ 

369.3 

226.0 

DE 586.4 

410.6 472.6 MD 455.1 414.6 448.9 471.9 380.4 433.7 

Guam 559.5 

763.2 604.9 602.1 Rate per 100,000

population 

559.4 <=150 (n=3) 

632.8 621.6 150.1-300 (n=12) 

354.2 >300 (n=38) 

464.6 

Puerto Rico 110.1 Virgin Is. 209.4 

Note: The total rate of chlamydia for women in the United States and outlying areas (including Guam, 

Puerto Rico and Virgin Islands) was 399.8 per 100,000 population. 

Figure B. Gonorrhea — Rates for women by state: United States and outlying areas, 2000 

37.2 

8.6 4.5 11.3 

29.0 69.4 

8.1 156.9 44.3 113.4 

13.0 181.5 VT 10.9 50.3 118.3 NH 8.7 99.7 69.6 177.3 MA 49.0 9.2 112.9 145.1 RI 74.1 58.1 75.5 40.0 138.2 CT 96.0 110.9 159.2 84.7 NJ 85.1 

DE 254.9 214.9 188.3 MD 172.2 72.7 141.6 64.8 137.1 201.8 

Guam 29.9 Rate per 100,000 263.3 246.3 population 388.6 

166.7 <20 (n=9) 

67.3 285.3 20-100 (n=21)

139.6 (n=23) >100 

40.4 

Puerto Rico 11.8 Virgin Is. 27.1 

Note: The total rate of gonorrhea for women in the United States and outlying areas (including Guam, 

Puerto Rico and Virgin Islands) was 126.5 per 100,000 population. The Healthy People year 

2010 objective is 19.0 per 100,000 population for women. 

STD Surveillance 2000 Special Focus Profiles STDs in Women and Infants 45 
Figure C. Primary and secondary syphilis — Rates for women by state: United States and 

outlying areas, 2000 

0.3 

0.0 0.0 0.0 

0.2 0.2 

0.0 0.0 0.9 0.1 

0.4 2.8 VT 0.0 

0.2 0.1 0.4 

0.4 

0.5 NH 

MA 

0.0 

0.6 0.1 2.9 6.4 RI 0.4 0.3 0.0 0.1 0.4 2.1 

0.1 1.3 CT 

NJ 

0.4 

0.5 

DE 0.3 

8.7 5.9 MD 4.3 3.3 3.1 0.6 4.4 4.8 

Guam 0.0 

4.9 2.8 4.0 Rate per 100,000

population 

1.5 <=.2 (n=19) 

0.0 4.3 .21-4 (n=26) 

2.1 >4 (n=8) 

0.2 

Puerto Rico 3.8 Virgin Is. 3.9 

Note: The total rate of primary and secondary syphilis for women in the United States and outlying 

areas (including Guam, Puerto Rico and Virgin Islands) was 1.8 per 100,000 population. The 

Healthy People year 2010 objective is 0.2 per 100,000 population. 

Figure D. Congenital syphilis — Rates for infants <1 year of age by state: United States and 

outlying areas, 2000 

0.0 

0.0 0.0 0.0 

0.0 0.0 

0.0 5.9 0.0 14.7

0.0 12.0 VT 0.0 0.0 6.2 NH 0.0 0.0 0.0 3.3 MA 0.0 2.2 0.0 27.4 RI 0.0 16.5 0.0 0.0 5.3 CT 2.3 5.2 4.0 5.5 NJ 19.2 

DE 0.0 16.1 31.0 MD 22.2 32.0 2.0 0.0 43.4 44.5 

Guam 0.0 Rate per 100,000 13.9 live births 11.3 32.6 

20.7 <1 (n=25) 

0.0 10.5 1-40 (n=26)

20.4 (n=2) >40 

0.0 

Puerto Rico 26.5 Virgin Is. 0.0 

Note: The total rate of congenital syphilis for infants <1 year of age for the United States and outlying 

areas (including Guam, Puerto Rico and Virgin Islands) was 13.6 per 100,000 live births. The 

Healthy People year 2010 objective is 1.0 per 100,000 live births. 

46 STDs in Women and Infants Special Focus Profiles STD Surveillance 2000 
Figure E. Congenital syphilis — Cases by prenatal care utilization: United States,
 

1995-2000
 

Cases 

Prenatal 

No prenatal 

Unknown 

0 

240 

480 

720 

960 

1,200 

1995	 1996 1997 1998 1999 2000
 

Figure F.	 Chlamydia — Positivity among 15-24 year old women tested in prenatal
 

clinics by state, 2000
 

Positivity (%) 

See * 

<5 

5.0-9.9 

>=10 

VT 

NH 

MA 

RI 

CT 

NJ 

DE 5.9 

MD 4.8 

DC 

Puerto Rico 14.5 Virgin Is. 

(n=29) 

(n=9) 

(n=12) 

(n=3) 

4.0 

8.0 

5.7 

3.3 

8.9 

4.9 

5.9 4.7 

13.1 

13.7 

4.6 

5.6 4.8 

6.8 

8.9 

7.0 

4.0 

9.2 

7.0 

9.3 2.2 

*States not reporting chlamydia positivity data in prenatal clinics.
 

Note: States reported chlamydia positivity data on at least 100 women aged 15-24 years during 2000.
 

SOURCE: Regional Infertility Prevention Programs; Office of Population Affairs; Local and State STD Control Programs;
 

Centers for Disease Control and Prevention 

STD Surveillance 2000 Special Focus Profiles STDs in Women and Infants 47
 
Figure G. Gonorrhea — Positivity among 15-24 year old women tested in prenatal
 

clinics by state, 2000
 

Positivity (%) 

See * 

<1 

1.0-1.9 

>=2 

VT 

NH 

MA 

RI 

CT 

NJ 

DE 

MD 

DC 

Puerto Rico Virgin Is. 

(n=38) 

(n=8) 

(n=3) 

(n=4) 

2.1 

1.5 

0.9 

1.1 

0.7 0.6 

3.7 

3.4 

0.2 

0.9 0.0 

0.0 0.9 2.5 

1.0 

*States not reporting gonorrhea positivity data in prenatal clinics. 

Note: States reported gonorrhea positivity data on at least 100 women aged 15-24 years during 2000. 

SOURCE: Regional Infertility Prevention Programs; Office of Population Affairs; Local and State STD Control Programs; 

Centers for Disease Control and Prevention 

Figure H. Ectopic pregnancy — Hospitalizations of women 15-44 years of age: United 

States, 1980-1999 

Ectopic Pregnancies (in thousands) 

0 

20 

40 

60 

80 

100 

1980 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99
 

Note: Some variations in 1981 and 1988 numbers may be due to changes in sampling 

procedures. The relative standard error for these estimates ranges from 8% to 11%. 

SOURCE: National Hospital Discharge Survey (National Center for Health Statistics, CDC) 

48 STDs in Women and Infants Special Focus Profiles STD Surveillance 2000
 
Figure I.	 Pelvic inflammatory disease — Hospitalizations of women 15-44 years of age: 

United States, 1980–1999 

Hospitalizations (in thousands)
 

300
 

240
 

180
 

120
 

60
 

0
 

Acute, Unspec. 

Chronic 

1980 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 

Note: The relative standard error for the estimates of the overall total number of PID cases range 

from 6% to 9%. 

SOURCE: National Hospital Discharge Survey (National Center for Health Statistics, CDC) 

Figure J.	 Pelvic inflammatory disease — Initial visits to physicians’ offices by women 

15-44 years of age: United States, 1980–2000 

Visits (in thousands) 

500 

400 

300 

200 

100 

0 

1980 82 84 86 88 90 92 94 96 98 2000
 

Note: See Appendix.
 

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
 

STD Surveillance 2000 Special Focus Profiles STDs in Women and Infants 49 
STDs in Adolescents and Young Adults
 

Public Health Impact 

Compared to older adults, adolescents (10- to 19-year-olds) and young adults (20- to 

24-year-olds) are at higher risk for acquiring STDs for a number of reasons: they may be more likely 

to have multiple (sequential or concurrent) sexual partners rather than a single, long-term relationship; they may be more likely to engage in unprotected intercourse; and they may select partners at 

higher risk. In addition, for some STDs, for example Chlamydia trachomatis, adolescent women 

may have a physiologically increased susceptibility to infection due to increased cervical ectopy. 

In addition, the higher prevalence of STDs among adolescents reflects multiple barriers to quality 

STD prevention services, including lack of insurance or other ability to pay, lack of transportation, 

discomfort with facilities and services designed for adults, and concerns about confidentiality. 

Observations 

•	 Numerous prevalence studies in various clinic populations have shown that sexually 

active adolescents have high rates of chlamydial infection.1-4 The Regional Infertility 

Prevention Programs that perform large scale screening for detecting chlamydial 

infections among women attending family planning clinics demonstrate that younger 

women consistently have higher positivity rates of chlamydia than older women, 

even as prevalence declines. An example is the Region X Chlamydia Project, which 

has screened women in family planning clinics since 1988 (Figure K). 

•	 Among women, 15- to 19-year-olds had the highest rate of gonorrhea in 2000 

compared to all other age categories (Figure Q). In addition, 20- to 29-year-old 

women had the highest rates of primary and secondary syphilis in 2000 (Figure 

S). Among men, 20- to 24-year-olds had the highest rate of gonorrhea and fourth 

highest rate of primary and secondary syphilis (Figures R and T). 

•	 Rates of gonorrhea among male adolescents generally decreased between the 

years 1996 and 2000 (Figure R). In the 10- to 14-year-old group, the rate for 

young men remained stable at about 8 cases per 100,000 males between 1999 

and 2000 (Table 20B). In the 15- to 19-year-old group, the rate declined from 

373.6 cases per 100,000 males in 1996 to 327.9 cases per 100,000 males in 

2000, a 12.2% decrease. Among young adult men in the 20- to 24-year-old 

group, the rate of gonorrhea increased between 1999 and 2000 (574.5 and 

589.8 cases per 100,000 males respectively). The rate in this age group in 2000 is 

10.7% higher than the rate of 532.7 cases per 100,000 males reported in 1996 

(Table 20B). 

•	 Gonorrhea among female adolescents and young adults aged 10- to 19-years 

also decreased between 1996 and 2000. In the 10- to 14-year-old group, the rate 

for females decreased 9.0% during this period from 58.6 cases per 100,000 

STD Surveillance 2000 Special Focus Profiles STDs in Adolescents and Young Adults 51 
females in 1996 to 53.3 cases per 100,000 females in 2000 (Table 20B). In the 

15- to 19-year-old group, the rate declined slightly by 1.3% from 724.7 to 715.6 

cases per 100,000 females between 1996 and 2000. In addition, the rates for 

female adolescents in these age groups decreased between the years 1999 and 

2000. Among young adult women in the 20- to 24-year-old group, the rate of 

gonorrhea increased by 3.7% from 633.4 to 656.6 cases per 100,000 females 

between 1999 and 2000. The 2000 rate for women in this age group was 21.0% 

greater than the age-group specific rate of 542.7 cases per 100,000 females 

reported in 1996 (Table 20B). 

•	 In 2000, the highest age-specific gonorrhea rates among women and the third 

highest rates among men were in the 15- to 19-year-old group (Figure 14). 

•	 Since 1990, approximately 20,000 female National Job Training Program 

entrants have been screened each year for chlamydia. This program, 

administered by the U.S. Department of Labor at more than 100 sites throughout 

the country, is a job training program for economically disadvantaged youth aged 

16 through 24 years. Among women entering the program from 30 states and 

Puerto Rico in 2000, based on their place of residence before program entry, the 

median state-specific chlamydia prevalence was 11.9% (range, 6.8% to 19.8%) 

(Figure L). Chlamydial infection is widespread geographically and highly 

prevalent among these economically disadvantaged young women.3 

•	 Since 1996, approximately 25,000 female recruits have been screened at entry in 

the U.S. Army at basic training in Fort Jackson, South Carolina.4 All tests are 

performed at the Johns Hopkins University Chlamydia Research Laboratory on 

urine specimens. Among women aged 17 to 37 years entering the Army in 1999, 

based on their state of residence before entry, the overall state-specific chlamydia 

prevalence was 9.9%. State-specific prevalence ranged from 4.1% to 19.6% 

(Figure M). Data for female recruits in 2000 were unavailable. 

•	 Among men aged 17 to 37 years entering the Army in 1999 and 2000, based on 

their state of residence before entry, the overall chlamydia prevalence was 4.7%. 

State-specific chlamydia prevalence ranged from 1.0% to 11.1% (Figure N). 

•	 Data from National Job Training Program centers submitting gonorrhea 

specimens to the national contract laboratory from female students aged 16 to 24 

years indicate a high prevalence of gonococcal infection in this population. 

Specimens from at least 100 students from each of 21 states and Puerto Rico, 

were tested by the contract laboratory; the median state-specific gonorrhea 

prevalence was 3.5% (range, 0.9% to 8.5%) in 2000 (Figure O). 

•	 Among men aged 17 to 37 years entering the Army in 1999 and 2000, based on 

their state of residence before entry, the overall gonorrhea prevalence was 0.4%. 

State-specific gonorrhea prevalence ranged from 0.0% to 1.4% (Figure P). 

1Centers for Disease Control and Prevention. Recommendations for the prevention and management of 

Chlamydia trachomatis infections, 1993. MMWR 1993;42(No. RR-12). 

2Lossick J, Delisle S, Fine D, Mosure D, Lee V, Smith C. Regional program for widespread screening for 

Chlamydia trachomatis in family planning clinics. In: Bowie WR, Caldwell HD, Jones RP, et al., eds. 

Chlamydial Infections: Proceedings of the Seventh International Symposium of Human Chlamydial Infections, Cambridge, Cambridge University Press 1990, pp. 575-9. 

52 STDs in Adolescents and Young Adults Special Focus Profiles STD Surveillance 2000 
3Mertz, KJ; Ransom RL; St. Louis ME, Groseclose SL; Hadgu A; Levine WC; Hayman C. Decline in the Prevalence of Genital Chlamydia Infection in Young Women Entering a National Job Training Program, 

1990-1997. Am J Pub Health 2001;91(8):1287-1290. 

4Gaydos CA, Howel MR, Pare B, et al. Chlamydia trachomatis infection in female military recruits. N Engl J 

Med 1998;339:739-44. 

STD Surveillance 2000 Special Focus Profiles STDs in Adolescents and Young Adults 53 
Figure K. Chlamydia — Positivity among women tested in family planning clinics by 

age group: Region X, 1988–2000 

Percent 

15 

<18 Years 

18-19 Years 

12 20-24 Years 

25-29 Years 

30+ Years 

9 

6 

3 

0 

1 9 8 8 8 9 9 0 9 1 9 2 9 3 9 4 9 5 9 6 9 7 9 8 9 9 2 0 0 0 

Note: Women who met screening criteria were tested. Trends not adjusted for changes in 

laboratory test method in 1994, 1999, and 2000 and associated increases in test sensitivity. 

SOURCE: Regional Infertility Prevention Programs: Region X Chlamydia Project (Alaska, Idaho, Oregon and Washington) 

Figure L.	 Chlamydia — Prevalence among 16-24 year-old women entering the National Job 

Training Program by state of residence, 2000 

6.8 

8.2 

11.9 

12.2 VT 

NH 

9.0 

13.8 

13.2 12.6 

14.6 9.3 

11.9 

7.8 

15.9 

7.9 

14.3 

MA 

RI 

CT 

NJ 

DE 

11.1 

13.6 

11.0 

14.0 MD 10.9 10.2 DC 13.9 8.6 10.1 

19.8 13.8 13.3 Prevalence (%) 

13.0 

15.2 

See * 

<10 

(n=22) 

(n=8) 

11.5 10.0-14.9 

>=15 

(n=20) 

(n=3) 

Puerto Rico 9.2 Virgin Is. 

*Fewer than 100 women residing in these states and entering the National Job Training Program 

were screened for chlamydia in 2000. 

Note: The overall chlamydia prevalence among female students entering the National Job Training 

Program in 2000 was 11.2%. 

SOURCE: U.S. Department of Labor 

54 STDs in Adolescents and Young Adults Special Focus Profiles STD Surveillance 2000 
Figure M. Chlamydia — Positivity among 17-37 year-old women entering the U.S. Army by 

state of residence, 1999 

7.8 

12.9 VT 

NH 4.1 MA 10.1 RI 

5.6 

7.1 

13.5 

CT 

NJ 10.8 

DE 

14.9 MD 5.8 

DC 

16.5 

19.6 18.1 14.9 Positivity (%) 

11.7 

15.1 

See * 

<5 

(n=36) 

(n=1) 

11.3 5.0-9.9 

>=10 

(n=4) 

(n=12) 

Puerto Rico Virgin Is. 

*Fewer than 100 women residing in these states and entering the U.S. Army were screened for 

chlamydia in 1999. 

Note: Screening female recruits from January - July, 1999. Overall chlamydia positivity was 9.9%. 

SOURCE: Johns Hopkins University Chlamydia Research Laboratory (funding initiative: Office of Defense Women’s 

Health Research) 

Figure N. Chlamydia — Positivity among 17-37 year-old men entering the U.S. Army by 

state of residence, 1999-2000 

2.7 

1.0 

3.7 

3.7 VT 

NH 3.4 MA 

1.3 

2.3 

3.5 4.6 

5.1 

3.7 

3.7 

RI 

CT 

NJ 

DE 

1.6 

6.4 MD 5.6 2.7 DC 5.5 6.8 8.8 

10.1 6.4 11.1 Positivity (%) 

7.7 

8.7 

See * 

<5 

(n=27) 

(n=14) 

5.0 5.0-9.9 

>=10 

(n=10) 

(n=2) 

Puerto Rico 2.6 Virgin Is. 

*Fewer than 100 men residing in these states and entering the U.S. Army were screened. 

Note: Screening male recruits from January - February 1999 and August 1999 - June 2000. 

Overall chlamydia positivity was 4.7%. 

SOURCE: Johns Hopkins University Chlamydia Research Laboratory (funding initiative: Aberdeen Proving Ground) 

STD Surveillance 2000 Special Focus Profiles STDs in Adolescents and Young Adults 55 
Figure O. Gonorrhea — Prevalence among 16-24 year-old women entering the National Job 

Training Program by state of residence, 2000 

0.9 

3.0 

VT 

NH 

4.3 

4.0 MA 1.8 1.9 RI 4.0 CT 1.2 1.2 8.5 NJ 4.4 DE 

MD 7.2 3.0 DC 1.9 2.8 

Prevalence (%) 7.0 6.7 7.9 

See * (n=31) 1.9 

<2 (n=8) 5.1 (n=8) 

>=5 

2.0-4.9 4.2 (n=6) 

Puerto Rico 1.0 Virgin Is. 

*Fewer than 100 women residing in these states and entering the National Job Training Program 

were screened for gonorrhea by the national contract laboratory in 2000. 

Note: Many training centers test female students for gonorrhea using local laboratories; these results 

are not available to CDC. For this map, gonorrhea test results for students at centers submitting 

specimens to the national contract laboratory were included if the number of gonorrhea tests 

submitted was greater than 90% of the number of chlamydia tests submitted. The overall 

gonorrhea prevalence among female students entering the National Job Training Program in 

2000 was 3.3%. 

SOURCE: U.S. Department of Labor 

Figure P. Gonorrhea — Positivity among 17-37 year-old men entering the U.S. Army by state 

of residence, 1999-2000 

0.0 

0.0 

0.3 

0.0 VT 

NH 0.0 MA 0.7 RI 0.8 0.5 CT 0.0 0.0 NJ 0.0 

DE 0.0 

MD 0.0 0.4 1.4 DC 0.0 0.0 0.6 

Positivity (%) 0.9 1.4 0.0 

See * (n=28) 0.5 

<.5 (n=16) 0.6 (n=7) 

>=1 

0.5-0.9 0.0 (n=2) 

Puerto Rico 0.0 Virgin Is. 

*Fewer than 100 men residing in these states and entering the U.S. Army were screened. 

Note: Screening male recruits from January - February 1999 and August 1999 - June 2000. Overall 

gonorrhea positivity was 0.4%. 

SOURCE: Johns Hopkins University Chlamydia Research Laboratory (funding initiative: Aberdeen Proving Ground) 

56 STDs in Adolescents and Young Adults Special Focus Profiles STD Surveillance 2000 
Figure Q. Gonorrhea — Age-specific rates among women 10-44 years of age: United 

States, 1981–2000 

Rate (per 100,000 population) 

1,500 

1,200 

900 

600 

300 

0 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

1981 83 85 87 89 91 93 95 97 99
 

Figure R. Gonorrhea — Age-specific rates among men 10-44 years of age: United States, 

1981–2000 

Rate (per 100,000 population)
 

2,000
 

1,600
 

1,200
 

800
 

400
 

0
 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

1981 83 85 87 89 91 93 95 97 99
 

STD Surveillance 2000 Special Focus Profiles STDs in Adolescents and Young Adults 57 
Figure S. Primary and secondary syphilis — Age-specific rates among women 10-44 

years of age: United States, 1981–2000 

Rate (per 100,000 population) 

75 

60 

45 

30 

15 

0 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

1 9 8 1 8 3 8 5 8 7 8 9 9 1 9 3 9 5 9 7 9 9 
 

Figure T.	 Primary and secondary syphilis — Age-specific rates among men 10-44 years of 

age: United States, 1981–2000 

Rate (per 100,000 population) 

75 

60 

45 

30 

15 

0 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

1 9 8 1 8 3 8 5 8 7 8 9 9 1 9 3 9 5 9 7 9 9 
 

58 STDs in Adolescents and Young Adults Special Focus Profiles STD Surveillance 2000 
STDs in Racial and Ethnic Minorities
 

Public Health Impact 

Surveillance data show higher reported rates of STDs among some minority racial or ethnic 

groups when compared with rates among whites. Race and ethnicity in the United States are risk 

markers that correlate with other more fundamental determinants of health status such as poverty, 

access to quality health care, health care seeking behavior, illicit drug use, and living in communities 

with high prevalence of STDs. Acknowledging the disparity in STD rates by race or ethnicity is one 

of the first steps in empowering affected communities to organize and focus on this problem. 

Surveillance data are based on cases of STDs reported to state and local health departments (see 

Appendix). In many areas, reporting from public sources, for example STD clinics, is more complete than reporting from private sources. Since minority populations may utilize public clinics more 

than whites, differences in rates between minorities and whites may be increased by this reporting 

bias. 

Observations 

•	 Although chlamydia is a widely distributed STD among all racial and ethnic 

groups, trends in positivity in women screened in HHS Region X (Alaska, Idaho, 

Oregon, and Washington) show consistently higher chlamydia positivity among 

minorities (Figure U). 

•	 In 2000, chlamydia positivity among sexually active 15- to 30-year old women 

screened at clinics of the Indian Health Service (IHS) in four IHS regions ranged 

from 3.9% to 9.9% (Figure V). 

•	 In 2000, 76.4% of the total number of cases of gonorrhea reported to CDC 

occurred among African-Americans (Table 20A). The reported rate of gonorrhea 

among African-Americans in 2000 was 827.0 cases per 100,000 persons. Among 

Hispanics, the 2000 reported gonorrhea rate was 78.1 cases per 100,000 

persons. These rates are 30 and 3 times higher than the rate reported among 

non-Hispanic whites in 2000 of 28.0 cases per 100,000 persons (Figure 13, Table 

20B). 

•	 Gonorrhea rates in 2000 were highest for African-Americans aged 15 to 24 

among all racial, ethnic, and age categories. In 2000, African-American women 

aged 15 to 19 years had a gonorrhea rate of 3,594.3 cases per 100,000 females. 

This rate is 19 times greater than the 2000 rate among non-Hispanic white 

females of similar age (188.9). African-American men in the 15- to 19-year old 

age category had a 2000 gonorrhea rate of 1,911.6 cases per 100,000 males, 

which was 50 times higher than the rate among 15- to 19-year old white males of 

38.1 (Table 20B). Among 20- to 24-year-olds in 2000, the gonorrhea rate among 

STD Surveillance 2000 Special Focus Profiles STDs in Racial and Ethnic Minorities 59 
African-Americans was 26 times greater than that among non-Hispanic whites 

(3,418.2 and 130.9 cases per 100,000 persons respectively) (Table 20B). 

•	 Despite declines in gonorrhea rates for most age and race/ethnic groups during 

the 1980s, African-American adolescent females aged 15 to 19 years did not 

show a decline in rates until 1991 (Figure W). Similarly, declines among 

African-American adolescent males did not begin until 1992 (Figure X). From 

1999 to 2000 gonorrhea rates among African-Americans declined slightly by 

2.5% (848.2 and 827.0 cases per 100,000 persons respectively). During the same 

period, gonorrhea rates increased by 11.7% among Hispanics, 43.5% among 

Asian/Pacific Islanders, and 4.1% among American Indians/Alaska Natives 

(Table 20B). 

•	 The epidemic of syphilis in the late 1980s was largely an epidemic in 

heterosexual, minority populations.1 From 1990 to 1996, rates of primary and 

secondary (P&S) syphilis declined among all racial and ethnic groups (Table 

32B). Since 1996, rates of P&S syphilis have generally been stable among all 

racial and ethnic groups except African-Americans, among whom rates have 

steadily declined. Rates for African-Americans and Hispanics continue to be 

higher than for non-Hispanic whites. In 2000, 70.8% of all cases of P&S syphilis 

reported to CDC occurred among African-Americans (Table 32A). Although the 

rate for African-Americans declined from 15.0 to 12.8 cases per 100,000 persons 

between 1999 and 2000, the 2000 rate was 21 times greater than the rate of 0.6 

per 100,000 persons among non-Hispanic whites. Between 1999 and 2000, P&S 

syphilis rates for African-American females aged 15 to 19 years declined by 

16.1%, and for African-American males in this age group by 6.4% (Figures Y and 

Z, Table 32B). Similarly, the P&S syphilis rate declined by 8.6% between 1999 

and 2000 among young African-American adults aged 20 to 24 years. The 2000 

rate of P&S syphilis among Hispanics was 1.8 cases per 100,000 persons, which 

is 3 times greater than the rate among non-Hispanic whites (Table 32B). 

•	 In 2000, the rate of congenital syphilis was 49.3 cases per 100,000 live births 

among African-Americans and 22.6 cases per 100,000 live births among 

Hispanics. These rates are 33 and 15 times greater than the 2000 rate of 1.5 cases 

per 100,000 live births among non-Hispanic whites respectively (Figure AA). 

Compared with 1999, the 2000 rate of congenital syphilis decreased by 15.9% 

among African-Americans but increased 12.4% among Hispanics. 

1Nakashima AK, Rolfs RT, Flock ML, Kilmarx P, Greenspan JR. Epidemiology of syphilis in the United States, 

1941 through 1993. Sex Transm Dis 1996;23:16-23. 

60 STDs in Racial and Ethnic Minorities Special Focus Profiles STD Surveillance 2000 
Figure U. Chlamydia — Positivity among women tested in family planning clinics 

by race and ethnicity: Region X, 1988–2000 

Percent 

15 

White 

Black 

Hispanic 

Asian/Pac Isl 12 Nat Am/AK Nat 

9 

6 

3 

0 

1988 89 90 91 92 93 94 95 96 97 98 99 2000 

Note: Women who met screening criteria were tested. Trends not adjusted for changes in 

laboratory test method and associated increases in test sensitivity in 1994, 1999, and 2000. 

SOURCE: Regional Infertility Prevention Programs: Region X Chlamydia Project (Alaska, Idaho, Oregon and Washington) 

Figure V. Chlamydia — Positivity among 15-30 year old women tested in Indian Health 

Service Clinics by IHS regions, 2000 

Alaska* 

Billings 

9.9 Aberdeen 

Portland* 7.7 

Bemidj* 

Phoenix* 

Nashville* 

Oklahoma 

California* 

3.9 

Tucson* 

Navajo* 

Albuquerque 

6.0 

*IHS regions not reporting chlamydia positivity data during 2000. 

SOURCE: Indian Health Service 

STD Surveillance 2000 Special Focus Profiles STDs in Racial and Ethnic Minorities 61 
Figure W. Gonorrhea — Reported rates for 15-19 year old females by race and ethnicity: 

United States, 1981–2000 

Rate (per 100,000 population) 

7,000 

5,600 

4,200 

2,800 

1,400 

0 

White 

Black 

Hispanic 

Asian/Pac Isl 

Nat Am/AK Nat 

1981 83 85 87 89 91 93 95 97 99
 

Figure X. Gonorrhea — Reported rates for 15-19 year old males by race and ethnicity: 

United States, 1981–2000 

Rate (per 100,000 population)
 

7,000
 

5,600
 

4,200
 

2,800
 

1,400
 

0
 

White 

Black 

Hispanic 

Asian/Pac Isl 

Nat Am/AK Nat 

1981 83 85 87 89 91 93 95 97 99
 

62 STDs in Racial and Ethnic Minorities Special Focus Profiles STD Surveillance 2000 
Figure Y. Primary and secondary syphilis — Reported rates for 15-19 year old females by 

race and ethnicity: United States, 1981–2000 

Rate (per 100,000 population) 

250 

200 

150 

100 

50 

0 

White 

Black 

Hispanic 

Asian/Pac Isl 

Nat Am/AK Nat 

1981 83 85 87 89 91 93 95 97 99
 

Figure Z.	 Primary and secondary syphilis — Reported rates for 15-19 year old males by 

race and ethnicity: United States, 1981–2000 

Rate (per 100,000 population)
 

125
 

100
 

75
 

50
 

25
 

0
 

White 

Black 

Hispanic 

Asian/Pac Isl 

Nat Am/AK Nat 

1981 83 85 87 89 91 93 95 97 99
 

STD Surveillance 2000 Special Focus Profiles STDs in Racial and Ethnic Minorities 63 
Figure AA.	 Congenital syphilis — Rates for infants <1 year of age by mother’s race and 

ethnicity: United States, 1991–2000 and the Healthy People year 2010 objective 

Rate (per 100,000 live births) 

450
 

360
 

270
 

180
 

90
 

0
 

White 

Black 

Hispanic 

Asian/Pac Isl 

Nat Am/AK Nat 

2010 Objective 

1 9 9 1 9 2 9 3 9 4 9 5 9 6 9 7 9 8 9 9 2 0 0 0 
 

Note: Less than 5% of cases had missing race/ethnicity information and were excluded. 

64 STDs in Racial and Ethnic Minorities Special Focus Profiles STD Surveillance 2000
 
STDs Among Men Who Have Sex with Men
 

Public Health Impact 

In the early 1980s, rates of reportable STDs among men who have sex with men (MSM) declined 

as they did for the rest of the U.S. population. Reports from several U.S. cities and the Gonococcal 

Isolate Surveillance Project (GISP) indicate that since 1993, an increasing number of MSM are acquiring STDs.1-4 These reports are consistent with analyses of available behavioral data that indicate 

an increase in the number of MSM participating in sexual behavior that places them at risk for STDs 

and HIV infection.5 Several factors may have contributed to this change, including the availability of 

highly active antiretroviral therapy (HAART).6 Because STDs and the behaviors associated with 

them increase the likelihood of acquiring and transmitting HIV infection,7 the rise in STDs among 

MSM may signal an increase in the incidence of HIV infection among MSM. 

Observations 

•	 In 2000, six STD clinics in five U.S. cities (Seattle, Philadelphia, the District of 

Columbia, Long Beach, and Chicago) submitted chlamydia, gonorrhea, syphilis, 

and HIV data to CDC as part of the Monitoring Trends in Prevalence of STDs, 

Tuberculosis, and HIV Risk Behaviors Among Men Who Have Sex with Men 

Project (MSM Project). The MSM Project includes data collected as a part of 

routine care at participating clinic sites. 

•	 Median STD clinic test positivity among MSM was 14% (range: 8-20%) for 

urethral gonorrhea; 7% (range: 5-13%) for rectal gonorrhea; 5% (range: 2-12%) 

for urethral chlamydia and 4% (0-12%) for HIV (Figure BB). 

•	 Among MSM attending these STD clinics, the median STD clinic prevalence of 

syphilis was 2% (range: 0-4%) (Figure BB). 

•	 STD and HIV positivity varied by race/ethnicity, but tended to be highest among 

African-American MSM (Figure BB). 

•	 Positivity for urethral gonorrhea was higher for HIV-positive than HIV-negative 

MSM. Among HIV-positive MSM, median STD clinic positivity for urethral 

gonorrhea was 21% compared with 12% among HIV-negative MSM. Rectal and 

pharyngeal gonorrhea positivity was the same for HIV-positive and HIV-negative 

MSM. Positivity for urethral chlamydia was 6% for HIV-negative and 2% for 

HIV-positive MSM (Figure CC). 

•	 The prevalence of syphilis was higher for HIV-positive than HIV-negative MSM. 

Among HIV-positive MSM, 6% had syphilis, compared with 1% of HIV-negative 

MSM (Figure CC). 

•	 GISP also reports the percentage of Neisseria gonorrhoeae isolates obtained from 

MSM. Overall, the proportion of isolates coming from MSM increased from 4% in 

1988 to 14% in 2000 in GISP clinics, with most of the increase occurring after 

STD Surveillance 2000 Special Focus Profiles STDs Among Men Who Have Sex with Men 65 
1993. The number of GISP clinics having >5% of GISP isolates from MSM rose 

from seven clinics in 1990 to 14 clinics in 2000. Among the 14 GISP clinics with 

>5% of isolates coming from MSM in 2000, the percentage of patients who were 

MSM ranged from 7% to 70%, with a median of 19% (Figure DD). Additional 

information on GISP may be found in the Gonorrhea section. 

1Centers for Disease Control and Prevention. Resurgent bacterial sexually transmitted disease among men 

who have sex with men- King County, Washington, 1997-1999. MMWR 1999;48:773-7. 

2Centers for Disease Control and Prevention. Outbreak of syphilis among men who have sex with men – 

Southern California, 2000. MMWR;50:117-20. 

3Centers for Disease Control and Prevention. Gonorrhea among men who have sex with men – Selected 

sexually transmitted disease clinics, 1993-1996. MMWR 1997;46:889-92. 

4Fox KK, del Rio C, Holmes K, et. al. Gonorrhea in the HIV era: A reversal in trends among men who have sex 

with men. Am J Public Health. 2001;91:959-964. 

5Stall R, Hays R, Waldo C, Ekstrand M, McFarland W. The gay ‘90s: a review of research in the 1990s on sexual behavior and HIV risk among men who have sex with men. AIDS 2000;14:S1-S14. 

6Scheer S, Chu PL, Klausner JD, Katz MH, Schwarcz SK. Effect of highly active antiretroviral therapy on diagnoses of sexually transmitted diseases in people with AIDS. Lancet 2001;357:432-5. 

7Fleming DT, Wasserheit JN. From epidemiologic synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect 

1999;48:773-7. 

8Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2000 Supplement: 

Gonococcal Isolate Surveillance Project (GISP) Annual Report 2000. Atlanta, GA: U.S. Department of 

Health and Human Services, Centers for Disease Control and Prevention, 2001 (in press). 

66 STDs Among Men Who Have Sex with Men Special Focus Profiles STD Surveillance 2000 
Figure BB.	 MSM Project — Median STD clinic test positivity for chlamydia, gonorrhea, HIV 

and syphilis prevalence among MSM, by race/ethnicity, 2000 

Median positivity 

White 

Black 

Hispanic 

0 

5 

10 

15 

20 

25 

Urethral 

gonorrhea 

Rectal 

gonorrhea 

Pharyngeal 

gonorrhea 

Urethral 

chlamydia 

HIV test 

positive 

New cases of 

syphilis 

Figure CC. MSM Project — Median STD clinic test positivity for chlamydia, gonorrhea, and 

syphilis prevalence among MSM, by self-reported HIV status, 2000 

Median positivity 

HIV-positive 

HIV-negative 

0 

5 

10 

15 

20 

25 

Urethral Rectal Pharyngeal Urethral New cases of 

gonorrhea gonorrhea gonorrhea chlamydia syphilis 

STD Surveillance 2000 Special Focus Profiles STDs Among Men Who Have Sex with Men 67 
Figure DD. Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria 

gonorrhoeae isolates obtained from MSM for STD clinics in 14 cities, 1998, 

1999 and 2000 

Percent 

1998 

1999 

2000 

0 

15 

30 

45 

60 

75 

ALB ANC ATL CHI DEN HON LBC MIA ORA PHX POR SDG SEA SFO 

Clinics 

Note: In 2000, these 14 clinics reported 91.7% (633/690) of GISP gonorrhea cases in men who 

have sex with men (MSM). In 1998 ALB reported 0.0% MSM. Clinics include: 

ALB=Albuquerque, NM; ANC=Anchorage, AK; ATL=Atlanta, GA; CHI=Chicago, IL; 

DEN=Denver, CO; HON=Honolulu, HI; LBC=Long Beach, CA; MIA=Miami, FL; 

ORA=Orange County, CA; PHX=Phoenix, AZ; POR=Portland, OR; SDG=San Diego, CA; 

SEA=Seattle, WA; and SFO=San Francisco, CA. 

68 STDs Among Men Who Have Sex with Men Special Focus Profiles STD Surveillance 2000 
STDs in Persons Entering Corrections Facilities
 

Public Health Impact 

Multiple studies and surveillance projects have demonstrated a high prevalence of STDs in persons entering jails and juvenile detention facilities.1 Screening for chlamydia, gonorrhea, and syphilis at intake offers an opportunity to identify infections, prevent complications, and reduce 

transmission in the community. In cities where routine syphilis screening in jails occurs, a substantial 

percentage of all reported cases are identified in jails.2 Compiling data and analyzing trends in STD 

prevalence in this population can provide one method for monitoring trends in STD prevalence in 

the community. 

Observations 

•	 In 2000, 10 states reported chlamydia, gonorrhea, or syphilis data to CDC as part 

of the Jail STD Prevalence Monitoring Project. Five states reported syphilis data 

as part of the Syphilis Elimination Initiative. Two states reported syphilis data as 

part of the Innovations in Syphilis Prevention Project. Fourteen states reported 

data (at least 100 test results) from corrections facilities as part of the Regional 

Infertility Prevention Programs, and five additional states reported data in 

response to CDC’s request for data. 

•	 The maps shown in this section represent approximately 273,000 syphilis tests for 

men and 54,000 syphilis tests for women, 76,000 chlamydia tests for men and 

46,000 chlamydia tests for women, and 112,000 gonorrhea tests for men and 

33,000 gonorrhea tests for women. 

•	 The median percentage of reactive syphilis tests was 6.4% (range, 0.8% to 

30.0%) for women entering 29 adult jails and 0.5% (range, 0.0% to 0.7%) for 

adolescent women entering three juvenile detention centers (Figure EE). The 

median percentage of reactive tests was 2.5% (range, 1.1% to 7.2%) for men at 

30 adult jails and 0.4% (range, 0.2% to 0.6%) at four juvenile facilities. The 

percentage of reactive syphilis tests was higher for women than for men in 29 

(91%) of 32 adult and juvenile facilities reporting syphilis test results for both 

sexes (Figures EE, FF). The percentage of reactive syphilis tests representing 

cases of syphilis varied from site to site. 

•	 The positivity for chlamydia and gonorrhea among women was higher in juvenile 

facilities than in adult facilities. Among adolescent women entering juvenile 

detention facilities, the median positivity for chlamydia was 15% (range, 1.5% to 

28.9%); positivity was greater than 10% in 17 (71%) of 24 facilities reporting data 

(Figure GG). 

•	 The median positivity for gonorrhea among women entering juvenile facilities 

was 4.9% (range, 0.5% to 13.0%); positivity was greater than 4% in 11 (73%) of 

15 juvenile facilities (Figure II). The median positivity for chlamydial infection 

STD Surveillance 2000 Special Focus Profiles STDs in Persons Entering Corrections Facilities 69 
among men entering juvenile facilities in 30 counties was 6.6% (range, 0.9% to 

13.0%) (Figure HH). 

•	 The median positivity for gonorrhea among men entering juvenile facilities in 18 

counties was 2.4% (range, 0.6% to 4.2%) (Figure JJ). 

1Mertz KJ, Voigt R, Hutchins K, Levine WC, and the Jail STD Prevalence Monitoring Group. High prevalence 

of sexually transmitted diseases in persons entering jails and juvenile detention centers in 13 United States 

counties. (Submitted 2001). 

2CDC. Syphilis screening among women arrestees at the Cook County Jail – Chicago, 1996. MMWR 

1998;47:432-3. 

70 STDs in Persons Entering Corrections Facilities Special Focus Profiles STD Surveillance 2000 
Figure EE. Syphilis serologic tests — Percent seroreactivity in women entering juvenile and 

adult corrections facilities†

, 2000 

†

From facilities reporting >100 test results. 

SOURCE: Local and State STD Control Programs; Regional Infertility Prevention Programs; Centers for Disease Control and 

Prevention 

Figure FF.	 Syphilis serologic tests — Percent seroreactivity in men entering juvenile and 

adult corrections facilities†

, 2000 

†

From facilities reporting >100 test results. 

SOURCE: Local and State STD Control Programs; Regional Infertility Prevention Programs; Centers for Disease Control and 

Prevention 

STD Surveillance 2000 Special Focus Profiles STDs in Persons Entering Corrections Facilities 71 
Figure GG. Chlamydia — Positivity in women entering juvenile and adult corrections 

facilities†

, 2000 

†

From facilities reporting >100 test results. 

SOURCE: Local and State STD Control Programs; Regional Infertility Prevention Programs; Centers for Disease Control and 

Prevention 

Figure HH.	 Chlamydia — Positivity in men entering juvenile and adult corrections 

facilities†

, 2000 

†

From facilities reporting >100 test results. 

SOURCE: Local and State STD Control Programs; Regional Infertility Prevention Programs; Centers for Disease Control and 

Prevention 

72 STDs in Persons Entering Corrections Facilities Special Focus Profiles STD Surveillance 2000 
Figure II. Gonorrhea — Positivity in women entering juvenile and adult corrections 

facilities†

, 2000 

†

From facilities reporting >100 test results. 

SOURCE: Local and State STD Control Programs; Regional Infertility Prevention Programs; Centers for Disease Control and 

Prevention 

Figure JJ.	 Gonorrhea — Positivity in men entering juvenile and adult corrections 

facilities†

, 2000 

†

From facilities reporting >100 test results. 

SOURCE: Local and State STD Control Programs; Regional Infertility Prevention Programs; Centers for Disease Control and 

Prevention 

STD Surveillance 2000 Special Focus Profiles STDs in Persons Entering Corrections Facilities 73 

STDs in the South
 

Public Health Impact 

The southern region of the United States consists of the District of Columbia and 16 states: 

Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, 

North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia. This region has consistently had higher reported rates of chlamydia, gonorrhea and primary and secondary (P&S) syphilis than the other regions of the country (Northeast, Midwest, and West). The 

reasons for these higher rates in the South are not well understood, but may include differences in 

the racial and ethnic distribution of the population, poverty, and availability and quality of health 

care services. Regional differences in STD rates are particularly disturbing in light of the fact that 

STDs can increase the risk of HIV transmission. The high HIV prevalence among childbearing 

women living in the South is consistent with the high rates of these other STDs in the region.1 

Observations 

•	 The South has consistently had higher rates of gonorrhea and P&S syphilis 

compared with other regions throughout the 1980s and 1990s (Figures 11 and 

24, Tables 13 and 25). From 1996 through 2000, the South also had a higher 

reported rate of chlamydia than the other regions of the country (Figure 4, Table 

4). 

•	 In 2000, six of the 10 states with the highest chlamydia rates were in the South 

(Figure 3, Table 3). Similarly, nine of the 10 states with the highest rates of 

gonorrhea were located in the South (Figure 10, Table 12). Fifteen of the 

southern states had 2000 reported rates of P&S syphilis that were greater than the 

Healthy People Year 2010 (HP2010) objective of 0.2 case per 100,000 persons 

(Figure 22, Table 23). All of these southern states had reported P&S syphilis rates 

in 2000 that were at least six times greater than the HP2010 objective (Figure 22, 

Table 23). 

•	 In 2000, 412 (69.2%) of 595 counties with P&S syphilis rates above the HP2010 

objective were located in the South (Figures 23 and KK). 

•	 Of the 412 counties in the South that had reported P&S syphilis rates in 2000 

above the HP2010 objective, 226 (55.9%) had an increase in the rate from 1999 

to 2000 (Figures KK and LL). 

•	 County-specific rates of chlamydia and gonorrhea in 2000 were calculated for 

those southern states submitting county level data (Figures MM and NN). These 

county level data were reported through the National Electronic 

Telecommunications System for Surveillance (NETSS), and are provisional for

all states shown except Alabama, Arkansas, Delaware, Florida, Kentucky,

Mississippi, Oklahoma, South Carolina, Texas, and Virginia where hardcopy 

STD Surveillance 2000 Special Focus Profiles	 STDs in the South 1 
reports have been discontinued based on consistent, high quality, and timely 

submissions of NETSS data (Figures A1 and A2 in Appendix). 

1Koumans EH, Sternberg M, Gwinn M, Swint E, Zaidi A, St. Louis M. Geographic variation of HIV infection in 

childbearing women with syphilis in the United States. AIDS 2000;14:279-87. 

2 STDs in the South Special Focus Profiles STD Surveillance 2000 
Figure KK. South — Primary and secondary syphilis case rates by county, 2000 

Figure LL. South — Increases and decreases in cases of primary and secondary syphilis in 

2000 compared with 1999 cases, by county 

*Decrease in cases in 2000 vs. 1999; 2000 rate >0.2/100,000 population. 

**Increase in cases in 2000 vs. 1999; 2000 rate >0.2/100,000 population. 

STD Surveillance 2000 Special Focus Profiles STDs in the South 3 
Figure MM. South — Chlamydia case rates by county, 2000 

SOURCE: National Electronic Telecommunications System for Surveillance (NETSS) data 

Figure NN. South — Gonorrhea case rates by county, 2000 

SOURCE: National Electronic Telecommunications System for Surveillance (NETSS) data 

4 STDs in the South Special Focus Profiles STD Surveillance 2000 
Table 1. Cases of sexually transmitted diseases reported by state health departments and rates per 100,000 

civilian population: United States, 1941–2000 

Syphilis 

Primary Lymphoand Early Late and Granuloma granuloma All Stages Secondary Latent Late Latent Congenital Chlamydia* Gonorrhea Chancroid Inguinale Venereum 

Year1 Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate2 Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate 

1941 485,560 368.2 68,231 51.7 109,018 82.6 202,984 153.9 17,600 13.4 NR . 193,468 146.7 3,384 2.5 639 0.4 1,381 1.0 

1942 479,601 363.4 75,312 57.0 116,245 88.0 202,064 153.1 16,918 12.8 NR . 212,403 160.9 5,477 4.1 1,278 0.9 1,888 1.4 

1943 575,593 447.0 82,204 63.8 149,390 116.0 251,958 195.7 16,164 12.6 NR . 275,070 213.6 8,354 6.4 1,748 1.3 2,593 2.0 

1944 467,755 367.9 78,443 61.6 123,038 96.7 202,848 159.6 13,578 10.7 NR . 300,676 236.5 7,878 6.1 1,759 1.3 2,858 2.2 

1945 359,114 282.3 77,007 60.5 101,719 79.9 142,187 111.8 12,339 9.7 NR . 287,181 225.8 5,515 4.3 1,857 1.4 2,631 2.0 

1946 363,647 271.7 94,957 70.9 107,924 80.6 125,248 93.6 12,106 9.0 NR . 368,020 275.0 7,091 5.2 2,232 1.6 2,603 1.9 

1947 355,592 252.3 93,545 66.4 104,124 73.9 122,089 86.6 12,200 8.7 NR . 380,666 270.0 9,515 6.7 2,330 1.7 2,526 1.8 

1948 314,313 218.2 68,174 47.3 90,598 62.9 123,312 85.6 13,931 9.7 NR . 345,501 239.8 7,661 5.3 2,469 1.7 2,429 1.7 

1949 256,463 175.3 41,942 28.7 75,045 51.3 116,397 79.5 13,952 9.5 NR . 317,950 217.3 6,707 4.6 2,402 1.6 1,925 1.3 

1950 217,558 146.0 23,939 16.7 59,256 39.7 113,569 70.2 13,377 9.0 NR . 286,746 192.5 4,977 3.3 1,783 1.2 1,427 1.0 

1951 174,924 116.1 14,485 9.6 43,316 28.7 98,311 65.2 11,094 7.4 NR . 254,470 168.9 4,233 2.8 1,352 0.9 1,300 0.9 

1952 167,762 110.2 10,449 6.9 36,454 24.0 105,238 69.1 8,553 5.6 NR . 244,957 160.8 3,738 2.5 951 0.6 1,200 0.8 

1953 148,573 95.9 8,637 5.6 28,295 18.3 98,870 63.8 7,675 5.0 NR . 238,340 153.9 3,338 2.2 667 0.4 983 0.6 

1954 130,687 82.9 7,147 4.5 23,861 15.1 89,123 56.5 6,676 4.2 NR . 242,050 153.5 3,003 1.9 618 0.4 875 0.6 

1955 122,392 76.2 6,454 4.0 20,054 12.5 86,526 53.8 5,354 3.3 NR . 236,197 147.0 2,649 1.7 490 0.3 762 0.5 

1956 130,201 78.7 6,392 3.9 19,783 12.0 95,097 57.5 5,491 3.3 NR . 224,346 135.7 2,135 1.3 357 0.2 500 0.3 

1957 123,758 73.5 6,576 3.9 17,796 10.6 91,309 54.2 5,288 3.1 NR . 214,496 127.4 1,637 1.0 348 0.2 448 0.3 

1958 113,884 66.4 7,176 4.2 16,556 9.7 83,027 48.4 4,866 2.8 NR . 232,386 135.6 1,595 0.9 314 0.2 434 0.3 

1959 120,824 69.2 9,799 5.6 17,025 9.8 86,740 49.7 5,130 2.9 NR . 240,254 137.6 1,537 0.9 265 0.2 604 0.3 

1960 122,538 68.8 16,145 9.1 18,017 10.1 81,798 45.9 4,416 2.5 NR . 258,933 145.4 1,680 0.9 296 0.2 835 0.5 

1961 124,658 68.8 19,851 11.0 19,486 10.8 79,304 43.8 4,163 2.3 NR . 264,158 145.8 1,438 0.8 241 0.1 787 0.4 

1962 126,245 68.7 21,067 11.5 19,585 10.7 79,533 43.3 4,070 2.2 NR . 263,714 143.6 1,344 0.7 207 0.1 590 0.3 

1963 124,137 66.6 22,251 11.9 18,235 9.8 78,076 41.9 4,031 2.2 NR . 278,289 149.2 1,220 0.7 173 0.1 586 0.3 

1964 114,325 60.4 22,969 12.1 17,781 9.4 68,629 36.3 3,516 1.9 NR . 300,666 159.0 1,247 0.7 135 0.1 732 0.4 

1965 112,842 58.9 23,338 12.2 17,458 9.1 67,317 35.1 3,564 1.9 NR . 324,925 169.6 982 0.5 155 0.1 878 0.5 

1966 105,159 54.4 21,414 11.1 15,950 8.2 63,541 32.9 3,170 1.6 NR . 351,738 181.9 838 0.4 148 0.1 308 0.2 

1967 102,581 52.5 21,053 10.8 15,554 8.0 61,975 31.7 2,894 1.5 NR . 404,836 207.3 784 0.4 154 0.1 371 0.2 

1968 96,271 48.8 19,019 9.6 15,150 7.7 58,564 29.7 2,381 1.2 NR . 464,543 235.7 845 0.4 156 0.1 485 0.2 

1969 92,162 46.3 19,130 9.6 15,402 7.7 54,587 27.4 2,074 1.0 NR . 534,872 268.6 1,104 0.6 154 0.1 520 0.3 

1970 91,382 45.3 21,982 10.9 16,311 8.1 50,348 24.9 1,953 1.0 NR . 600,072 297.2 1,416 0.7 124 0.1 612 0.3 

1971 95,997 46.9 23,783 11.6 19,417 9.5 49,993 24.4 2,052 1.0 NR . 670,268 327.2 1,320 0.6 89 0.0 692 0.3 

1972 91,149 43.9 24,429 11.8 20,784 10.0 43,456 20.9 1,758 0.8 NR . 767,215 369.7 1,414 0.7 81 0.0 756 0.4 

1973 87,469 41.7 24,825 11.8 23,584 11.3 37,054 17.7 1,527 0.7 NR . 842,621 402.0 1,165 0.6 62 0.0 408 0.2 

1974 83,771 39.6 25,385 12.0 25,124 11.9 31,854 15.1 1,138 0.5 NR . 906,121 428.2 945 0.4 47 0.0 394 0.2 

1975 80,356 37.6 25,561 12.0 26,569 12.4 27,096 12.7 916 0.4 NR . 999,937 467.7 700 0.3 60 0.0 353 0.2 

1976 71,761 33.2 23,731 11.0 25,363 11.7 21,905 10.1 626 0.3 NR . 1,001,994 464.1 628 0.3 71 0.0 365 0.2 

1977 64,621 29.6 20,399 9.4 21,329 9.8 22,313 10.2 463 0.2 NR . 1,002,219 459.5 455 0.2 75 0.0 348 0.2 

1978 64,875 29.4 21,656 9.8 19,628 8.9 23,038 10.4 434 0.2 NR . 1,013,436 459.7 521 0.2 72 0.0 284 0.1 

1979 67,049 30.1 24,874 11.2 20,459 9.2 21,301 9.6 332 0.1 NR . 1,004,058 450.3 840 0.4 76 0.0 250 0.1 

1980 68,832 30.5 27,204 12.1 20,297 9.0 20,979 9.3 277 0.1 NR . 1,004,029 445.1 788 0.3 51 0.0 199 0.1 

1981 72,799 32.0 31,266 13.7 21,033 9.2 20,168 8.9 287 0.1 NR . 990,864 435.2 850 0.4 66 0.0 263 0.1 

1982 75,579 32.9 33,613 14.6 21,894 9.5 19,799 8.6 259 0.1 NR . 960,633 417.9 1,392 0.6 17 0.0 235 0.1 

1983 74,637 32.1 32,698 14.1 23,738 10.2 17,896 7.7 239 0.1 NR . 900.435 387.6 847 0.4 24 0.0 335 0.1 

1984 69,873 29.8 28,607 12.2 23,132 9.9 17,829 7.6 305 0.1 7,594 6.5 878,556 374.8 665 0.3 30 0.0 170 0.1 

1985 67,563 28.5 27,131 11.5 21,689 9.2 18,414 7.8 329 0.1 25,848 17.4 911,419 384.3 2,067 0.9 44 0.0 226 0.1 

STD Surveillance 2000 National Summary Tables 79 
Table 1. Cases of sexually transmitted diseases reported by state health departments and rates per 100,000 

civilian population: United States, 1941–2000 (continued) 

Syphilis 

Chlamydia* Gonorrhea Chancroid 

Granuloma 

Inguinale 

Lymphogranuloma All Stages Venereum

Primary 

and 

Secondary Early Latent 

Late and 

Late Latent Congenital 

Year1 Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate2 Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate 

1986 67,771 28.3 27,667 11.6 21,656 9.0 18,046 7.5 410 0.2 58,001 35.2 892,229 372.8 3,045 1.3 48 0.0 307 0.1 

1987 87,278 35.9 35,585 14.6 28,233 11.6 22,988 9.4 480 0.2 91,913 50.8 787,532 323.6 4,986 2.0 22 0.0 302 0.1 

1988 104,546 42.5 40,474 16.5 35,968 14.6 27,363 11.1 741 0.3 157,807 87.1 738,160 300.3 4,891 2.0 11 0.0 194 0.1 

1989 115,067 46.6 45,826 18.6 45,394 18.4 22,032 8.9 1,837 0.7 200,904 102.5 733,294 297.1 4,697 1.9 7 0.0 182 0.1 

1990 135,043 54.3 50,578 20.3 55,397 22.3 25,750 10.4 3,865 1.6 323,663 160.8 690,042 277.4 4,212 1.7 97 0.0 277 0.1 

1991 128,637 51.0 42,950 17.0 53,855 21.4 27,490 10.9 4,424 1.8 381,228 180.3 621,918 246.7 3,476 1.4 29 0.0 471 0.2 

1992 112,855 44.3 33,962 13.3 49,903 19.6 25,099 9.8 4,067 1.6 409,634 183.4 502,785 197.1 1,885 0.7 6 0.0 289 0.1 

1993 101,335 39.3 26,497 10.3 41,902 16.3 29,675 11.5 3,420 1.3 405,275 179.5 444,578 172.5 1,237 0.5 19 0.0 286 0.1 

1994 82,334 31.6 20,645 7.9 32,020 12.3 27,452 10.5 2,452 0.9 451,758 194.5 419,577 165.7 779 0.3 3 0.0 237 0.1 

1995 69,353 26.4 16,543 6.3 26,657 10.1 24,296 9.2 1,857 0.7 478,577 190.4 392,651 149.4 607 0.2 0 0.0 188 0.1 

1996 53,218 20.1 11,388 4.3 20,187 7.6 20,364 7.7 1,279 0.5 490,681 192.9 326,809 123.2 386 0.1 10 0.0 72 0.0 

1997 46,710 17.5 8,556 3.2 16,631 6.2 20,446 7.6 1,077 0.4 531,744 207.0 326,564 122.0 246 0.1 8 0.0 114 0.0 

1998 38,367 14.2 7,035 2.6 12,741 4.7 17,752 6.6 839 0.3 607,752 234.2 355,728 131.6 189 0.1 3 0.0 86 0.0 

1999 35,379 13.0 6,617 2.4 11,535 4.2 16,654 6.1 573 0.2 659,108 251.6 359,931 132.0 142 0.1 19 0.0 63 0.0 

2000 31,575 11.6 5,979 2.2 9,470 3.5 15,597 5.7 529 0.2 702,093 257.5 358,995 131.6 78 0.0 4 0.0 42 0.0 

*NR = No report 

1

For 1941-1946, data were reported for the federal fiscal year ending June 30 of the year indicated. From 1947 to the present, data were reported for the 

calendar year ending December 31. For 1941-1958, data for Alaska and Hawaii were not included. 

2

For 1941-1994, rates include all cases of congenitally acquired syphilis per 100,000 population. As of 1995, rates of congenital syphilis <1 year of age 

per 100,000 population are reported. For rates of congenital syphilis <1 year of age per 100,000 live births see Tables 37, 38 and 39. As of 1995, 

cases of congenital syphilis <1 year of age are obtained in hardcopy and electronic format based on case reporting form CDC 73.126. 

Note: Adjustments to the number of cases reported from state health departments were made for hardcopy forms and for electronic data submissions 

through May 4, 2001 (see Appendix). The number of cases and the rates shown here supersede those published in previous reports. Cases and rates 

shown in this table exclude the outlying areas of Guam, Puerto Rico and Virgin Islands. 

80 National Summary Tables STD Surveillance 2000 
Table 2. Reported cases of sexually transmitted disease by gender and reporting source: United States, 2000

†

Non-STD Clinic STD Clinic Total

Disease* Male Female Total Male Female Total Male Female Total

Total Chlamydia Trachomatis 78,767 458,614 538,970 58,278 104,563 163,100 137,049 563,206 702,093

Chlamydial PID‡ NA 2,719 2,725 NA 435 445 NA 3,154 3,170

Ophthalmia Neonatorum 106 123 233 4 7 11 110 130 244

Total Gonorrhea 86,517 132,193 219,348 92,854 46,657 139,639 179,375 178,854 358,995

Gonococcal PID NA 2,803 2,808 NA 475 482 NA 3,278 3,290

Ophthalmia Neonatorum 24 13 37 5 4 9 29 17 46

Total Syphilis NA NA NA NA NA NA 17,020 14,478 31,575

Primary 567 168 735 986 249 1,236 1,553 417 1,971

Secondary 998 1,025 2,023 981 1,003 1,985 1,979 2,028 4,008

Early Latent 2,393 2,496 4,892 2,496 2,079 4,578 4,889 4,575 9,470

Late and Late Latent+ 4,583 4,312 8,911 3,767 2,907 6,686 8,350 7,219 15,597

Neurosyphilis§ 236 87 324 5 5 10 241 92 334

Congenital <1year¥ NR NR NR NR NR NR 249 239 529

Chancroid 7 12 19 39 20 59 46 32 78

Granuloma Inguinale 1 1 2 0 2 2 1 3 4

Lymphogranuloma Venereum 8 7 15 18 9 27 26 16 42

Genital Herpes¤ 674 2,793 3,470 1,567 1,048 2,616 2,241 3,841 6,086

Other and Nonspecified PID¤ NA 936 940 NA 1,156 1,158 NA 2,092 2,098

 ¤

*NA = Not applicable. NR = No report.

†Totals include unknown gender and reporting source.

‡

PID = Pelvic inflammatory disease. 

§

Neurosyphilis cases are not included with Total Syphilis cases but are included in the late and late latent syphilis cases. 

+Cases of unknown duration for syphilis are included in late and late latent syphilis. 

¥

Cases of congenital syphilis <1 year of age are obtained using reporting from CDC 73.126. Clinic reporting source is not available from that form. ¤

Not nationally notifiable, and only reported by a few states on hardcopy reporting forms.
STD Surveillance 2000 National Summary Tables 81
Rank State/Area Cases Rate per 100,000 Population

1 Mississippi 12,697 458.6

2 Alaska 2,569 414.7

3 Louisiana 17,846 408.2

4 Delaware 2,856 379.0

5 Georgia 29,359 377.0

6 Alabama 15,323 350.7

7 Texas 68,814 343.3

8 Guam 525 321.1

9 Wisconsin 16,365 311.7

10 Hawaii 3,547 299.2

11 New Mexico 5,204 299.1

12 Colorado 12,000 295.8

13 California 95,392 287.8

14 North Carolina 21,985 287.4

15 Maryland 14,533 281.0

16 Oklahoma 9,331 277.9

17 Ohio 31,190 277.1

18 Tennessee 15,069 274.8

19 Illinois 32,991 272.0

20 Michigan 26,237 266.0

21 Rhode Island 2,632 265.6

22 Arizona 12,591 263.5

U.S. TOTAL1 702,093 257.5

23 South Carolina 9,950 256.1

24 South Dakota 1,834 250.2

25 Missouri 13,448 245.9

26 Arkansas 6,219 243.8

27 Indiana 14,063 236.6

28 Connecticut 7,604 231.7

29 Kansas 6,056 228.2

30 Nebraska 3,791 227.5

31 Washington 13,066 227.0

32 Virginia 15,352 223.4

33 Nevada 4,019 222.1

34 Florida 33,390 221.0

35 Pennsylvania 26,475 220.7

36 Oregon 7,107 214.3

37 Iowa 5,987 208.6

38 Kentucky 8,063 203.6

39 Massachusetts 10,967 177.6

40 New York † 31,494 173.1

41 Minnesota 8,102 169.7

42 Wyoming 807 168.3

43 Montana 1,469 166.4

44 Idaho 1,907 152.4

45 North Dakota 909 143.5

46 New Jersey 10,814 132.8

47 West Virginia 2,144 118.7

48 Maine 1,474 117.6

49 Virgin Islands 131 116.1

50 Utah 2,190 102.8

51 New Hampshire 1,130 94.1

52 Vermont 526 88.6

53 Puerto Rico 2,695 69.3

Table 3. Chlamydia — Reported cases and rates by state/area, ranked by rates: United States and 

outlying areas, 2000

†New York City has been reporting chlamydia cases since 1984. However, the State of New York, with the exception of New York City, initiated

chlamydia reporting during the year 2000. As a result, the number of chlamydia cases reported by the state of New York (including the cities of

Buffalo, Rochester and Yonkers) may be incomplete and the rate for New York State is underestimated. See Appendix.

1

Includes cases reported by Washington, D.C., but excludes outlying areas (Guam, Puerto Rico and Virgin Islands).

82 Chlamydia Tables STD Surveillance 2000
Table 4. Chlamydia — Reported cases and rates by state/area and region listed in alphabetical order: United

States and outlying areas, 1996–2000

Cases Rates per 100,000 Population

State/Area 1996 1997 1998 1999 2000 1996 1997 1998 1999 2000

Alabama 8,306 8,704 10,065 12,375 15,323 193.7 201.5 231.3 283.2 350.7

Alaska 1,360 1,616 1,907 1,886 2,569 224.8 265.2 310.6 304.4 414.7

Arizona 10,692 10,783 11,489 12,111 12,591 241.1 236.7 246.1 253.5 263.5

Arkansas 2,111 2,503 4,123 5,865 6,219 84.2 99.2 162.4 229.9 243.8

California 61,593 68,737 76,519 85,156 95,392 193.3 213.0 234.2 256.9 287.8

Colorado‡ 7,282 7,749 9,113 10,848 12,000 190.8 199.1 229.5 267.4 295.8

Connecticut 6,269 6,377 6,977 7,422 7,604 191.9 195.0 213.1 226.1 231.7

Delaware 2,271 2,613 2,608 2,761 2,856 313.9 357.2 350.7 366.4 379.0

Florida 24,763 26,788 24,949 31,410 33,390 171.7 182.8 167.3 207.9 221.0

Georgia 13,555 15,911 25,250 30,368 29,359 184.8 212.5 330.4 389.9 377.0

Hawaii 1,816 1,829 2,604 3,165 3,547 153.5 154.1 218.3 267.0 299.2

Idaho 1,524 1,709 2,035 1,778 1,907 128.3 141.2 165.6 142.0 152.4

Illinois 24,430 23,024 26,363 32,870 32,991 206.2 193.5 218.9 271.0 272.0

Indiana 10,334 9,600 10,801 11,734 14,063 177.3 163.7 183.1 197.4 236.6

Iowa 4,165 4,907 5,174 5,511 5,987 146.2 172.0 180.8 192.1 208.6

Kansas 4,449 4,627 5,587 6,093 6,056 172.5 178.3 212.5 229.6 228.2

Kentucky 6,805 6,332 6,441 7,378 8,063 175.3 162.0 163.6 186.3 203.6

Louisiana 11,020 11,545 15,188 16,635 17,846 253.9 265.3 347.6 380.5 408.2

Maine 967 1,066 1,073 1,220 1,474 78.1 85.8 86.2 97.4 117.6

Maryland 11,901 13,978 13,097 13,568 14,533 235.2 274.4 255.1 262.4 281.0

Massachusetts 6,837 7,984 8,363 8,776 10,967 112.4 130.5 136.0 142.1 177.6

Michigan 19,865 21,399 22,156 23,107 26,237 204.1 218.9 225.7 234.3 266.0

Minnesota 5,607 6,631 6,970 7,450 8,102 120.6 141.5 147.5 156.0 169.7

Mississippi 4,848 10,020 10,614 11,545 12,697 178.8 367.0 385.7 417.0 458.6

Missouri 11,959 12,257 12,670 13,355 13,448 223.0 226.9 233.0 244.2 245.9

Montana 1,124 1,146 1,412 1,584 1,469 128.2 130.4 160.4 179.4 166.4

Nebraska 2,544 2,766 2,911 3,616 3,791 154.3 166.9 175.1 217.0 227.5

Nevada 2,847 2,887 3,320 3,086 4,019 177.8 172.2 190.1 170.6 222.1

New Hampshire 732 816 960 976 1,130 63.1 69.6 81.0 81.3 94.1

New Jersey 12,273 10,339 11,686 12,424 10,814 153.4 128.4 144.0 152.6 132.8

New Mexico 4,007 4,021 3,793 5,017 5,204 234.2 232.5 218.4 288.4 299.1

New York† 26,455 28,468 26,218 26,766 31,494 360.7 387.7 353.3 360.3 173.1

North Carolina 15,078 17,108 22,197 21,812 21,985 206.3 230.4 294.1 285.1 287.4

North Dakota 1,016 902 1,036 947 909 158.1 140.7 162.3 149.4 143.5

Ohio 20,653 22,827 27,786 29,398 31,190 185.0 204.1 247.9 261.2 277.1

Oklahoma 7,379 7,419 9,393 8,195 9,331 223.9 223.7 280.7 244.0 277.9

Oregon 5,457 5,270 5,855 6,127 7,107 170.7 162.5 178.4 184.8 214.3

Pennsylvania 19,275 19,838 24,629 27,019 26,475 160.1 165.0 205.2 225.3 220.7

Rhode Island 1,833 2,069 2,307 2,345 2,632 185.5 209.5 233.4 236.7 265.6

South Carolina 9,391 12,511 18,510 18,499 9,950 252.7 332.7 482.5 476.1 256.1

South Dakota 1,538 1,439 1,572 1,544 1,834 208.5 195.0 213.0 210.6 250.2

Tennessee 13,125 12,502 13,717 14,216 15,069 247.3 232.9 252.6 259.2 274.8

Texas 43,003 50,675 60,436 62,958 68,814 225.3 260.7 305.9 314.1 343.3

Utah 1,598 1,774 2,209 2,219 2,190 79.2 86.2 105.2 104.2 102.8

Vermont 398 434 413 485 526 67.9 73.7 69.9 81.7 88.6

Virginia 11,756 11,955 13,561 13,735 15,352 176.4 177.5 199.7 199.8 223.4

Washington 9,236 9,523 10,998 11,964 13,066 167.3 169.7 193.3 207.8 227.0

West Virginia 2,325 3,108 2,791 1,820 2,144 127.7 171.2 154.1 100.7 118.7

Wisconsin 10,290 9,554 13,999 14,462 16,365 200.0 184.8 268.0 275.4 311.7

Wyoming 621 635 725 787 807 129.4 132.4 150.8 164.1 168.3

U.S. TOTAL1 490,681 531,744 607,752 659,108 702,093 192.9 207.0 234.2 251.6 257.5

Northeast 75,039 77,391 82,626 87,433 93,116 184.4 189.7 201.7 212.9 179.7

Midwest 116,850 119,933 137,025 150,087 160,973 187.9 192.0 217.9 237.3 254.5

South 189,635 216,741 256,122 275,860 286,136 203.9 230.1 268.4 286.0 296.6

West 109,157 117,679 131,979 145,728 161,868 186.6 198.1 219.0 238.3 264.7

Guam 304 368 410 497 525 199.1 235.6 256.5 303.9 321.1

Puerto Rico 2,481 2,123 1,685 1,445 2,695 66.7 55.5 43.7 37.2 69.3

Virgin Islands 11 14 10 136 131 10.0 12.8 9.1 120.5 116.1

OUTLYING AREAS 2,796 2,505 2,105 2,078 3,351 70.2 61.2 51.0 49.9 80.4

TOTAL 493,477 534,249 609,857 661,186 705,444 191.0 204.7 231.3 248.5 254.8

‡

The number of chlamydia cases occurring in the fourth quarter of 2000 for the State of Colorado was projected based on case counts from the first 

three quarters.

†New York City has been reporting chlamydia cases since 1984. However, the State of New York, with the exception of New York City, initiated

chlamydia reporting during the year 2000. As a result, the number of chlamydia cases reported by the state of New York (including the cities of

Buffalo, Rochester and Yonkers) may be incomplete and the rate for New York State is underestimated. See Appendix.

1

Includes cases reported by Washington, D.C., and rates exclude population of states that did not report.

STD Surveillance 2000 Chlamydia Tables 83
Table 5. Chlamydia — Women – Reported cases and rates by state/area listed in alphabetical order: United

States and outlying areas, 1996–2000

Cases Rates per 100,000 Population

State/Area 1996 1997 1998 1999 20000 1996 1997 1998 1999 20000

Alabama 7,623 7,957 9,197 11,524 13,746 342.4 354.9 406.2 507.1 604.9

Alaska 1,071 1,291 1,479 1,456 1,863 373.4 446.6 506.9 494.5 632.8

Arizona 8,635 8,597 9,015 9,497 10,008 385.9 374.3 382.0 393.4 414.6

Arkansas 1,933 2,346 3,850 4,618 5,015 149.4 180.3 293.4 350.3 380.4

California 49,158 53,536 59,747 66,334 72,178 309.1 332.4 365.6 400.4 435.7

Colorado 5,692 5,958 6,979 8,172 8,748 295.9 303.8 348.5 399.5 427.7

Connecticut 5,321 5,282 5,828 6,053 6,238 316.8 314.4 345.8 358.3 369.3

Delaware 1,877 2,070 2,117 2,268 2,271 506.0 551.9 554.2 585.6 586.4

Florida 20,160 21,953 20,171 25,957 27,562 271.8 291.5 262.7 333.6 354.2

Georgia 11,744 13,927 21,156 24,685 24,067 312.3 363.1 539.2 617.6 602.1

Hawaii 1,568 1,548 2,209 2,557 2,757 267.5 262.4 371.4 430.9 464.6

Idaho 1,177 1,336 1,553 1,308 1,435 198.1 220.8 252.3 208.5 228.8

Illinois 21,111 17,302 21,845 25,593 25,319 348.2 284.4 353.9 412.0 407.6

Indiana 8,592 7,819 8,823 9,410 10,935 287.5 260.2 291.3 308.4 358.4

Iowa 3,443 3,900 4,077 4,208 4,480 235.9 267.0 277.6 285.8 304.3

Kansas 3,744 3,840 4,649 5,034 4,973 285.8 291.5 347.8 373.3 368.7

Kentucky 5,604 5,128 5,126 5,891 6,466 280.8 255.3 253.0 289.2 317.4

Louisiana 9,490 9,414 12,169 13,247 14,099 422.0 417.6 536.5 584.0 621.6

Maine 829 898 899 991 1,143 130.8 141.4 141.0 154.5 178.1

Maryland 10,249 12,180 11,093 11,351 12,099 394.6 466.0 420.2 427.0 455.1

Massachusetts 5,783 6,522 6,812 6,959 8,452 183.7 206.2 214.0 217.7 264.4

Michigan 16,851 18,289 18,769 18,869 20,905 337.7 365.1 372.4 372.6 412.8

Minnesota 4,328 4,953 5,119 5,469 5,856 183.7 208.7 213.5 225.8 241.7

Mississippi 4,100 8,590 9,185 9,953 11,005 291.0 605.6 640.9 690.3 763.2

Missouri 10,578 10,749 11,063 11,515 11,525 382.7 386.5 394.4 408.5 408.9

Montana 899 941 1,131 1,192 1,097 204.4 213.5 255.4 268.5 247.1

Nebraska 2,084 2,288 2,390 2,903 3,018 247.8 270.9 281.4 341.0 354.5

Nevada 2,463 2,484 2,820 2,500 3,124 313.9 302.3 328.8 281.5 351.7

New Hampshire 578 639 726 769 889 98.1 107.4 120.6 126.0 145.7

New Jersey 11,463 9,641 10,735 11,123 9,486 278.2 232.6 256.6 265.0 226.0

New Mexico 3,417 3,503 3,204 4,177 4,171 394.1 399.5 363.1 472.6 471.9

New York† 24,375 25,706 23,449 23,896 26,928 628.7 662.8 596.4 607.9 285.7

North Carolina 13,072 14,553 18,646 18,416 18,625 347.9 381.5 479.8 467.3 472.6

North Dakota 714 684 755 680 663 221.9 212.9 235.5 213.5 208.2

Ohio 18,050 19,727 23,248 23,380 25,105 313.4 342.0 401.4 402.0 431.7

Oklahoma 6,269 6,269 7,696 6,737 7,715 372.4 370.1 449.4 392.0 448.9

Oregon 4,095 3,848 4,307 4,462 5,192 253.3 234.8 259.3 265.8 309.3

Pennsylvania 17,227 17,257 20,878 22,470 21,389 275.9 277.0 335.0 360.8 343.4

Rhode Island 1,600 1,738 1,779 1,769 1,969 312.0 339.4 346.5 343.8 382.7

South Carolina 7,918 11,120 16,489 16,669 8,721 412.2 572.2 829.7 829.0 433.7

South Dakota 1,184 1,021 1,171 1,194 1,308 316.6 272.9 312.2 320.4 351.0

Tennessee 10,004 9,605 10,552 11,084 11,648 365.0 346.4 375.5 390.7 410.6

Texas 37,240 42,750 49,940 52,071 56,817 385.6 435.0 498.7 512.7 559.4

Utah 1,229 1,357 1,616 1,618 1,610 121.4 131.3 153.0 151.0 150.3

Vermont 336 379 357 414 432 112.9 126.9 118.9 137.3 143.2

Virginia 10,630 10,452 11,567 11,556 12,976 312.7 304.2 332.9 328.8 369.2

Washington 7,194 7,331 8,377 8,880 9,583 259.7 260.5 292.8 306.8 331.1

West Virginia 1,894 2,590 2,340 1,585 1,790 201.1 275.8 249.3 169.2 191.1

Wisconsin 8,170 7,459 10,846 11,225 12,352 312.5 284.2 408.2 420.4 462.6

Wyoming 521 536 595 649 667 218.6 225.1 248.8 271.9 279.5

U.S. TOTAL1 415,051 441,921 501,266 536,729 563,206 319.5 337.1 377.6 400.8 404.0

Guam 260 325 351 432 430 362.3 442.6 467.3 562.1 559.5

Puerto Rico 1,989 1,722 1,327 1,147 2,226 103.4 86.5 66.1 56.7 110.1

Virgin Islands 11 13 10 113 108 19.3 22.8 17.4 219.1 209.4

OUTLYING AREAS 2,260 2,060 1,688 1,692 2,764 110.1 97.1 78.9 78.7 128.5

TOTAL 417,311 443,981 502,954 538,421 565,970 316.2 333.3 372.9 395.7 399.8

†New York City has been reporting chlamydia cases since 1984. However, the State of New York, with the exception of New York City, initiated

chlamydia reporting during the year 2000. As a result, the number of chlamydia cases reported by the state of New York (including the cities of

Buffalo, Rochester and Yonkers) may be incomplete and the rate for New York State is underestimated. See Appendix. 1

Includes cases reported by Washington, D.C., and rates exclude population of states that did not report. 

NOTE: Cases and rates underestimated in some areas because of under-reporting or non-reporting by gender.

84 Chlamydia Tables STD Surveillance 2000 
Table 6. Chlamydia — Men – Reported cases and rates by state/area listed in alphabetical order: United

States and outlying areas, 1996–2000

Cases* Rates per 100,000 Population

State/Area 1996 1997 1998 1999 2000 1996 1997 1998 1999 2000

Alabama 662 708 844 795 1,432 32.1 34.1 40.4 37.9 68.3

Alaska 289 325 428 430 706 90.8 101.5 132.8 132.3 217.2

Arizona 2,057 2,186 2,474 2,614 2,583 93.6 96.8 107.1 110.6 109.2

Arkansas 178 143 267 1,247 1,204 14.7 11.7 21.8 101.1 97.7

California 12,157 14,875 16,525 18,236 22,759 76.2 92.0 101.2 110.0 137.3

Colorado 1,585 1,784 2,115 2,666 3,251 83.7 92.4 107.5 132.6 161.7

Connecticut 948 1,095 1,149 1,369 1,366 59.7 68.9 72.3 85.9 85.8

Delaware 394 543 491 493 585 111.8 152.3 135.8 134.6 159.7

Florida 4,603 4,835 4,363 5,341 5,828 65.7 67.9 60.3 72.9 79.5

Georgia 1,811 1,962 3,932 5,462 5,102 50.7 53.7 105.7 144.1 134.6

Hawaii 248 281 395 583 777 41.6 47.1 66.0 98.5 131.2

Idaho 347 373 482 446 462 58.5 61.6 78.6 71.4 74.0

Illinois 3,319 5,722 4,518 7,263 7,670 57.4 98.5 76.9 122.8 129.6

Indiana 1,742 1,773 1,968 2,313 3,093 61.3 62.0 68.6 80.0 107.0

Iowa 722 1,007 1,096 1,302 1,505 52.0 72.4 78.6 93.2 107.7

Kansas 705 787 938 1,059 1,083 55.5 61.6 72.6 81.1 83.0

Kentucky 1,201 1,182 1,093 1,328 1,513 63.7 62.2 57.2 69.0 78.7

Louisiana 1,530 2,131 3,019 3,388 3,747 73.1 101.6 143.7 161.0 178.1

Maine 138 168 174 229 331 22.8 27.7 28.7 37.5 54.1

Maryland 1,652 1,798 1,973 2,196 2,379 67.1 72.5 79.1 87.4 94.7

Massachusetts 1,054 1,462 1,551 1,817 2,515 35.9 49.5 52.3 61.0 84.5

Michigan 3,014 3,110 3,387 4,237 5,331 63.6 65.3 70.9 88.3 111.1

Minnesota 1,279 1,678 1,851 1,981 2,246 55.8 72.6 79.5 84.2 95.5

Mississippi 703 1,200 1,355 1,450 1,647 54.0 91.5 102.7 109.3 124.1

Missouri 1,381 1,508 1,607 1,840 1,923 53.1 57.5 61.0 69.4 72.6

Montana 180 198 281 392 371 41.2 45.2 64.2 89.3 84.6

Nebraska 454 473 520 712 769 56.2 58.2 63.9 87.4 94.4

Nevada 384 403 498 586 893 47.0 47.1 56.0 63.6 97.0

New Hampshire 154 177 234 207 241 27.0 30.6 40.1 35.0 40.8

New Jersey 801 689 944 1,281 1,279 20.6 17.6 24.0 32.5 32.4

New Mexico 590 518 589 839 1,001 69.9 60.7 68.9 98.0 116.9

New York† 2,080 2,762 2,669 2,846 4,436 60.2 79.7 76.5 81.4 50.6

North Carolina 2,006 2,555 3,551 3,396 3,359 56.5 70.8 97.0 91.5 90.5

North Dakota 302 218 281 267 246 94.1 68.2 88.5 84.7 78.1

Ohio 2,405 2,884 4,211 5,604 5,819 44.5 53.2 77.7 103.0 106.9

Oklahoma 1,110 1,150 1,697 1,458 1,616 68.9 70.8 103.8 88.9 98.6

Oregon 1,362 1,422 1,548 1,665 1,915 86.2 88.6 95.5 101.7 116.9

Pennsylvania 2,048 2,581 3,751 4,549 5,086 35.3 44.6 65.0 78.9 88.2

Rhode Island 233 331 528 576 663 49.0 69.6 111.1 120.9 139.2

South Carolina 881 1,215 1,837 1,679 1,127 49.1 66.9 99.4 89.5 60.1

South Dakota 354 417 400 348 523 97.4 114.6 110.2 96.5 145.1

Tennessee 3,121 2,897 3,165 3,132 3,421 121.6 111.6 120.8 118.3 129.3

Texas 5,763 7,925 10,301 10,597 11,829 61.1 82.5 105.7 107.2 119.6

Utah 368 417 593 601 580 36.6 40.7 56.8 56.8 54.8

Vermont 62 55 56 71 94 21.5 19.0 19.3 24.3 32.2

Virginia 1,109 1,379 1,988 2,177 2,359 33.9 41.8 59.9 64.8 70.2

Washington 2,042 2,192 2,621 3,084 3,483 74.3 78.4 92.7 107.8 121.7

West Virginia 429 515 448 233 350 48.8 58.7 51.3 26.8 40.2

Wisconsin 2,120 2,095 3,144 3,212 4,006 83.7 82.3 122.5 124.5 155.3

Wyoming 100 99 130 138 140 41.4 41.0 53.8 57.3 58.1

U.S. TOTAL1 74,411 88,614 104,440 120,051 137,049 59.8 70.5 82.4 93.8 102.8

Guam 44 43 59 65 95 54.4 51.9 69.7 75.0 109.6

Puerto Rico 492 401 358 298 469 27.4 21.8 19.3 16.0 25.1

Virgin Islands NR 1 NR 23 23 . 1.9 . 37.5 37.5

OUTLYING AREAS 536 445 417 386 587 28.6 22.6 21.5 19.2 29.1

TOTAL 74,947 89,059 104,857 120,437 137,636 59.3 69.7 81.5 92.6 101.7

†New York City has been reporting chlamydia cases since 1984. However, the State of New York, with the exception of New York City, initiated

chlamydia reporting during the year 2000. As a result, the number of chlamydia cases reported by the state of New York (including the cities of

Buffalo, Rochester and Yonkers) may be incomplete and the rate for New York State is underestimated. See Appendix.

*NR = No report (see Appendix).

1

Includes cases reported by Washington, D.C., and rates exclude population of states that did not report.

STD Surveillance 2000 Chlamydia Tables 85
Table 7. Chlamydia — Reported cases and rates in selected cities of >200,000 population, ranked by rates: 

United States and outlying areas, 2000

Rank City Cases Rate per 100,000 Population

1 Richmond, VA 2,230 1,175.5

2 Milwaukee, WI 9,018 995.1

3 Philadelphia, PA 13,584 958.2

4 Baltimore, MD 5,433 858.7

5 New Orleans, LA 3,817 828.1

6 St Louis, MO 2,711 811.8

7 Detroit, MI 9,989 797.0

8 Atlanta, GA 5,558 746.2

9 Minneapolis, MN 2,652 724.3

10 Kansas City, MO 3,128 692.7

11 Indianapolis, IN 5,506 679.0

12 Denver, CO 3,164 633.1

13 Washington, DC 3,205 617.5

14 St Paul, MN 1,639 605.1

15 Boston, MA 3,229 580.4

16 Memphis, TN 4,967 569.0

17 Cincinnati, OH 4,715 561.0

18 Newark, NJ 1,567 553.2

19 Birmingham, AL 3,601 547.7

20 Oklahoma City, OK 2,060 502.5

21 Norfolk, VA 1,093 483.9

22 Dallas, TX 9,976 483.8

23 Corpus Christi, TX 1,525 483.4

24 Jacksonville, FL 3,501 474.1

25 Portland, OR 2,306 461.6

26 Tulsa, OK 1,770 461.2

27 Nashville, TN 2,403 453.4

28 Albuquerque, NM 2,368 452.4

29 Omaha, NE 1,935 433.6

30 Austin, TX 3,113 428.2

31 San Antonio, TX 5,871 427.6

32 Chicago, IL 12,693 425.9

33 Columbus, OH 4,298 418.2

34 San Francisco, CA 3,093 414.2

35 Sacramento, CA 4,599 388.2

36 Oakland, CA 4,975 384.5

37 Houston, TX 12,213 375.7

38 Toledo, OH 1,646 368.7

39 Los Angeles, CA 31,074 355.8

40 New York City, NY† 26,170 352.3

41 Honolulu, HI 2,932 339.1

42 Wichita, KS 1,457 322.6

43 El Paso, TX 2,225 317.0

44 Fort Worth, TX 4,214 304.8

45 San Diego, CA 8,591 304.6

46 Des Moines, IA 1,075 294.8

47 Charlotte, NC 1,873 288.9

48 Cleveland, OH 3,961 288.8

49 Tampa, FL 2,714 288.6

50 Jersey City, NJ 624 285.8

51 Phoenix, AZ 7,987 279.1

52 Seattle, WA 4,495 270.0

53 Louisville, KY 1,656 246.1

54 San Jose, CA 3,908 237.2

55 Buffalo, NY† 722 230.0

56 Pittsburgh, PA 2,885 229.6

57 Tucson, AZ 1,786 222.2

58 St Petersburg, FL 1,834 208.8

59 Dayton, OH 1,176 207.8

60 Yonkers, NY† 379 194.7

61 Akron, OH 990 184.1

62 Miami, FL 3,032 139.4

63 San Juan, PR 966 91.8

64 Rochester, NY† 115 48.0

†New York City has been reporting chlamydia cases since 1984. However, the State of New York, with the exception of New York City, initiated

chlamydia reporting during the year 2000. As a result, the number of chlamydia cases reported by the state of New York (including the cities of

Buffalo, Rochester and Yonkers) may be incomplete and the rate for New York State is underestimated. See Appendix.

86 Chlamydia Tables STD Surveillance 2000
Table 8. Chlamydia — Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1996–2000

Cases*

Cityy 1996 1997 1998 1999 2000

Rates per 100,000 Population

1996 1997 1998 1999 2000

Akron, OH 711

Albuquerque, NM 1,624

Atlanta, GA 4,091

Austin, TX 2,699

Baltimore, MD 4,812

Birmingham, AL 2,349

Boston, MA 1,985

852

1,635

4,208

2,977

6,066

2,372

2,450

859

1,715

5,276

3,030

5,663

2,476

2,588

841

1,674

5,572

2,795

5,286

2,209

2,680

990

2,368

5,558

3,113

5,433

3,601

3,229

134.2

309.3

572.5

395.9

716.4

355.4

355.8

160.3 159.7 156.4 184.1

310.8 326.1 319.8 452.4

582.4 713.6 748.1 746.2

429.2 426.4 384.4 428.2

922.9 877.2 835.5 858.7

360.1 375.4 336.0 547.7

439.5 465.2 481.7 580.4

Buffalo, NY NR NR NR NR 722 . . . . 230.0†

Charlotte, NC 803

Chicago, IL 12,356

Cincinnati, OH 1,699

Cleveland, OH 3,465

Columbus, OH 2,267

Corpus Christi, TX 1,070

Dallas, TX 5,309

Dayton, OH 509

Denver, CO 2,563

Des Moines, IA 727

Detroit, MI 7,460

El Paso, TX 2,457

Fort Worth, TX 1,864

Honolulu, HI 1,473

Houston, TX 8,488

Indianapolis, IN 4,814

Jacksonville, FL 2,431

Jersey City, NJ 647

Kansas City, MO 3,165

Los Angeles, CA 20,196

Louisville, KY 1,761

Memphis, TN 4,474

Miami, FL 2,606

Milwaukee, WI 5,568

Minneapolis, MN 1,922

Nashville, TN 1,965

New Orleans, LA 4,140

1,049

9,375

2,617

3,056

3,133

986

7,990

813

2,726

567

6,622

1,439

2,402

1,488

10,756

3,693

2,402

553

3,086

23,346

1,598

4,244

3,579

5,121

2,473

1,820

2,869

1,695

11,009

4,840

3,650

3,854

1,220

8,893

929

2,834

743

7,351

1,697

4,089

2,205

11,561

4,584

1,913

678

3,105

24,160

1,253

4,791

3,486

7,758

2,555

1,981

3,331

1,669

14,863

3,801

3,446

3,997

1,158

9,355

1,256

3,371

922

7,753

1,898

3,752

2,631

10,511

4,641

2,703

724

2,738

27,614

1,447

5,025

4,010

7,641

2,584

2,202

3,651

1,873

12,693

4,715

3,961

4,298

1,525

9,976

1,176

3,164

1,075

9,989

2,225

4,214

2,932

12,213

5,506

3,501

624

3,128

31,074

1,656

4,967

3,032

9,018

2,652

2,403

3,817

134.7

423.3

198.5

248.0

223.9

340.0

266.2

90.0

516.3

205.9

681.7

358.7

143.4

169.4

272.5

590.8

335.3

298.2

710.7

237.5

262.6

517.3

127.9

606.4

501.2

368.8

873.1

171.0 268.7 257.4 288.9

321.7 369.6 498.7 425.9

307.3 571.2 452.3 561.0

220.4 264.4 251.2 288.8

308.0 377.4 388.9 418.2

310.6 385.7 367.1 483.4

394.9 433.6 453.7 483.8

144.8 166.4 222.0 207.8

546.3 567.9 674.5 633.1

160.1 206.5 252.8 294.8

608.0 583.3 618.6 797.0

205.1 241.4 270.4 317.0

181.0 301.7 271.4 304.8

171.1 252.7 304.3 339.1

340.6 360.6 323.4 375.7

453.9 563.6 572.3 679.0

327.9 260.0 366.0 474.1

253.9 308.1 331.6 285.8

690.2 687.0 606.3 692.7

272.7 280.2 316.2 355.8

238.3 186.4 215.0 246.1

490.1 551.4 575.6 569.0

175.0 162.0 184.3 139.4

563.4 850.9 843.1 995.1

645.1 700.9 705.7 724.3

341.0 371.0 415.4 453.4

611.6 715.5 792.1 828.1

New York City, NY 26,455 28,468 26,218 26,766 26,170 360.7 387.7 353.3 360.3 352.3†

Newark, NJ 1,944

Norfolk, VA 801

Oakland, CA 3,375

Oklahoma City, OK 2,154

Omaha, NE 1,213

Philadelphia, PA 8,118

Phoenix, AZ 6,342

Pittsburgh, PA 2,494

Portland, OR 1,937

Richmond, VA 2,036

1,669

899

3,419

1,013

1,349

10,480

6,580

2,879

1,844

2,175

1,725

954

3,651

2,008

1,410

11,763

7,549

2,980

2,128

1,619

1,881

920

4,111

1,768

1,808

12,660

7,660

2,879

2,018

1,972

1,567

1,093

4,975

2,060

1,935

13,584

7,987

2,885

2,306

2,230

680.5

344.3

272.7

490.9

277.0

551.0

242.7

193.0

395.2

1,066.2

586.5 606.6 664.1 553.2

391.9 443.3 407.3 483.9

272.8 285.3 317.7 384.5

229.9 492.6 431.3 502.5

305.9 317.7 405.1 433.6

722.1 819.0 893.1 958.2

244.0 271.1 267.7 279.1

224.8 234.9 229.1 229.6

374.2 427.4 403.9 461.6

1,130.5 833.8 1,039.5 1,175.5

Rochester, NY NR NR NR NR 115 . . . . 48.0†

Sacramento, CA 3,584

San Antonio, TX 4,338

San Diego, CA 5,642

San Francisco, CA 1,819

San Jose, CA 2,971

Seattle, WA 3,229

St Louis, MO 2,386

St Paul, MN 1,054

St Petersburg, FL 1,522

Tampa, FL 2,083

Toledo, OH 484

Tucson, AZ 2,201

Tulsa, OK 1,663

Washington, DC 1,998

Wichita, KS 1,086

3,499

4,838

6,397

2,243

2,751

3,174

2,653

1,112

1,789

2,836

528

1,888

793

3,069

1,159

4,005

5,909

7,044

2,616

3,349

3,486

2,921

1,233

1,692

2,240

780

1,610

1,782

3,182

861

4,469

5,731

7,591

2,718

3,428

3,949

3,090

1,349

1,760

2,757

1,043

1,908

1,636

2,720

1,532

4,599

5,871

8,591

3,093

3,908

4,495

2,711

1,639

1,834

2,714

1,646

1,786

1,770

3,205

1,457

321.5

330.1

210.7

249.2

187.1

200.1

683.1

382.8

175.3

232.8

107.1

286.7

435.9

370.5

250.9

310.8 350.0 377.3 388.2

363.1 436.7 417.4 427.6

235.0 253.3 269.1 304.6

306.3 350.8 364.0 414.2

171.0 204.1 208.1 237.2

194.4 210.7 237.2 270.0

776.0 860.8 925.3 811.8

402.8 455.8 498.1 605.1

205.2 192.7 200.3 208.8

311.8 242.1 293.1 288.6

117.0 173.9 233.6 368.7

242.0 203.6 237.4 222.2

205.5 468.4 426.3 461.2

580.2 608.3 524.1 617.5

264.2 192.2 339.2 322.6

Yonkers, NY NR NR NR NR 379 . . . . 194.7†

U.S. CITY TOTAL1 217,399 229,867 252,487 266,544 289,026

San Juan, PR 916 739 615 501 966

TOTAL 218,315 230,606 253,102 267,045 289,992

317.3 333.5 361.8 379.6 407.2

105.0 84.7 58.8 47.6 91.8

314.6 330.4 357.3 374.7 402.6

†New York City has been reporting chlamydia cases since 1984. However, the State of New York, with the exception of New York City, initiated

chlamydia reporting during the year 2000. As a result, the number of chlamydia cases reported by the state of New York (including the cities of

Buffalo, Rochester and Yonkers) may be incomplete and the rate for New York State is underestimated. See Appendix.

*NR = No report (see Appendix). 1

Rates exclude population of cities that did not report.

STD Surveillance 2000 Chlamydia Tables 87
Table 9. Chlamydia — Women – Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1996–2000

Cases*

Cityy 1996 1997 1998 1999 2000

Rates per 100,000 Population

1996 1997 1998 1999 2000

Akron, OH 616

Albuquerque, NM 1,332

Atlanta, GA 3,190

Austin, TX 2,257

Baltimore, MD 4,442

Birmingham, AL 2,258

Boston, MA 1,584

666

1,386

3,596

2,468

5,607

2,269

1,842

697

1,437

4,217

2,463

5,066

2,352

1,920

653

1,401

4,287

2,367

4,700

2,086

2,107

769

1,815

4,468

2,432

4,828

2,792

2,360

223.7

496.3

855.2

660.5

1,237.5

642.3

548.6

241.2 249.1 233.1 274.6

515.1 532.6 521.4 675.5

954.0 1,090.7 1,101.3 1,147.8

710.2 689.4 647.6 665.4

1,595.4 1,470.5 1,393.0 1,430.9

647.6 668.6 595.2 796.6

638.8 665.9 731.6 819.5

Buffalo, NY NR NR NR NR 528 . . . . 323.3†

Charlotte, NC 702

Chicago, IL 11,428

Cincinnati, OH 1,538

Cleveland, OH 3,059

Columbus, OH 1,830

Corpus Christi, TX 888

Dallas, TX 4,123

Dayton, OH 471

Denver, CO 1,907

Des Moines, IA 583

Detroit, MI 6,409

El Paso, TX 2,241

Fort Worth, TX 1,586

Honolulu, HI 1,244

Houston, TX 7,811

Indianapolis, IN 3,718

Jacksonville, FL 1,840

Jersey City, NJ 628

Kansas City, MO 2,890

Los Angeles, CA 15,813

Louisville, KY 1,345

Memphis, TN 3,427

Miami, FL 2,106

Milwaukee, WI 4,574

Minneapolis, MN 1,437

Nashville, TN 1,428

New Orleans, LA 3,593

576

6,362

2,349

2,672

2,666

802

6,159

756

2,076

430

5,863

1,263

1,968

1,236

9,326

2,680

1,753

536

2,779

17,911

1,248

3,325

2,884

4,051

1,710

1,308

2,266

1,395

9,480

4,122

3,173

3,027

1,031

6,699

729

2,146

581

6,491

1,421

3,278

1,850

9,912

3,472

1,368

657

2,785

18,930

985

3,786

2,799

6,219

1,762

1,426

2,574

1,373

11,415

3,211

2,955

2,907

999

7,143

834

2,468

660

6,343

1,599

2,933

2,102

8,740

3,481

2,091

681

2,413

21,564

1,136

4,020

3,282

6,076

1,756

1,628

2,794

1,498

9,378

3,938

3,183

3,185

1,292

7,726

863

2,190

789

7,716

1,881

3,317

2,239

10,222

3,896

2,809

605

2,763

23,056

1,301

3,943

2,449

7,077

1,759

1,758

2,772

227.5

756.6

341.9

413.8

349.4

553.7

407.3

160.2

747.3

317.3

1,114.4

635.8

240.8

288.5

499.1

871.3

492.0

562.3

1,242.3

371.2

381.0

757.7

199.1

950.4

728.9

511.6

1,413.7

181.5 426.3 408.0 445.1

422.1 612.7 737.0 605.5

524.9 923.7 724.9 889.0

364.3 433.7 406.3 437.6

506.7 571.6 545.0 597.1

495.9 634.1 615.9 796.5

600.1 642.4 681.6 737.2

259.1 250.2 282.2 292.0

809.8 837.9 962.3 853.9

233.4 309.6 347.1 414.9

1,024.4 978.8 961.0 1,169.0

349.9 387.8 435.6 512.4

292.7 477.7 419.6 474.6

285.5 423.8 484.8 516.4

588.1 612.8 533.4 623.9

629.4 814.3 818.2 915.8

464.1 359.9 546.9 734.8

477.8 577.2 603.0 535.7

1,190.7 1,175.9 1,020.1 1,168.1

417.6 435.2 489.4 523.3

353.7 277.8 319.8 366.3

734.0 830.3 877.4 860.6

271.8 248.6 288.0 214.9

850.5 1,298.3 1,271.8 1,481.3

868.1 938.6 931.3 932.9

467.7 507.9 584.4 631.0

901.0 1,029.3 1,129.3 1,120.4

New York City, NY 24,375 25,706 23,449 23,896 22,663 628.7 662.8 596.4 607.9 576.6†

Newark, NJ 1,887

Norfolk, VA 705

Oakland, CA 2,793

Oklahoma City, OK 1,887

Omaha, NE 994

Philadelphia, PA 7,483

Phoenix, AZ 4,937

Pittsburgh, PA 2,064

Portland, OR 1,410

Richmond, VA 1,835

1,615

801

2,715

892

1,107

9,300

5,064

2,416

1,248

1,931

1,632

826

2,942

1,585

1,139

10,182

5,653

2,415

1,453

1,452

1,684

795

3,212

1,449

1,437

10,479

5,787

2,380

1,379

1,713

1,330

964

3,851

1,686

1,516

10,724

6,195

2,398

1,597

1,900

1,256.2

624.1

446.0

830.9

439.5

948.3

373.7

301.0

562.5

1,760.2

1,079.4 1,090.5 1,130.3 892.7

719.3 754.7 727.4 882.0

427.1 452.9 490.0 587.4

391.1 747.8 680.5 791.8

486.2 495.6 622.2 656.4

1,196.5 1,321.5 1,377.2 1,409.4

371.8 401.2 399.9 428.1

355.5 358.2 356.2 358.9

495.4 571.4 540.5 625.9

1,837.7 1,360.3 1,643.0 1,822.3

Rochester, NY NR NR NR NR 86 . . . . 69.5†

Sacramento, CA 2,855

San Antonio, TX 3,775

San Diego, CA 4,143

San Francisco, CA 1,324

San Jose, CA 2,414

Seattle, WA 2,352

St Louis, MO 2,194

St Paul, MN 782

St Petersburg, FL 1,213

Tampa, FL 1,707

Toledo, OH 420

Tucson, AZ 1,796

Tulsa, OK 1,375

Washington, DC 1,764

Wichita, KS 878

2,750

4,093

4,733

1,426

2,135

2,279

2,442

830

1,486

2,371

480

1,510

622

2,658

915

3,069

4,854

5,394

1,541

2,594

2,430

2,630

897

1,391

1,851

630

1,299

1,467

2,722

665

3,452

4,697

5,839

1,541

2,636

2,654

2,736

972

1,446

2,380

815

1,531

1,331

2,391

1,218

3,391

4,767

6,371

1,819

2,948

3,006

2,362

1,154

1,511

2,319

1,348

1,411

1,485

2,786

1,134

500.5

557.7

312.3

358.6

307.2

288.7

1,155.5

546.0

262.5

372.5

178.3

459.5

698.1

615.2

398.4

477.0 526.0 571.9 561.8

596.5 692.0 661.0 670.8

350.8 388.1 417.0 455.0

384.3 409.3 408.9 482.6

268.0 318.7 322.6 360.8

276.6 289.5 314.5 356.2

1,314.7 1,430.9 1,512.5 1,305.8

578.3 635.4 687.3 816.0

320.7 299.0 310.9 324.8

509.5 389.7 492.8 480.2

204.1 269.0 349.4 577.9

380.5 321.3 372.6 343.4

312.3 744.0 670.1 747.7

946.7 978.9 866.4 1,009.5

409.6 290.5 528.1 491.6

Yonkers, NY NR NR NR NR 327 . . . . 321.0†

U.S. CITY TOTAL1 183,660 188,314 206,412 214,055 226,646

San Juan, PR 681 580 445 385 761

TOTAL 184,341 188,894 206,857 214,440 227,407

520.9 531.2 573.1 590.9 619.0

142.0 120.9 81.8 70.4 139.1

515.8 525.7 565.7 583.2 612.0

†New York City has been reporting chlamydia cases since 1984. However, the State of New York, with the exception of New York City, initiated

chlamydia reporting during the year 2000. As a result, the number of chlamydia cases reported by the state of New York (including the cities of

Buffalo, Rochester and Yonkers) may be incomplete and the rate for New York State is underestimated. See Appendix.

*NR = No report (see Appendix). 1

Rates exclude population of cities that did not report.

88 Chlamydia Tables STD Surveillance 2000
Table 10. Chlamydia — Men – Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1996–2000

Cases*

Cityy 1996 1997 1998 1999 20000

Rates per 100,000 Population

1996 1997 1998 1999 20000

Akron, OH 92 

Albuquerque, NM 292 

Atlanta, GA 899 

Austin, TX 442 

Baltimore, MD 370 

Birmingham, AL 85 

Boston, MA 401 

179 

249 

597 

509 

459 

101 

608 

161 

278 

1,038 

564 

566 

123 

668 

183 

272 

1,262 

428 

565 

117 

573 

216 

521 

1,079 

676 

550 

700 

869 

36.1

113.7

263.2

130.0

118.3

27.5

149.0

70.0 62.4 71.0 83.8

96.9 108.5 106.8 204.5

172.7 294.3 354.9 303.5

147.1 159.6 118.4 187.0

150.1 188.0 191.3 186.3

32.8 40.0 38.1 228.1

226.0 249.2 213.5 323.8

Buffalo, NY NR NR NR NR 194 . . . . 128.8†

Charlotte, NC 101 

Chicago, IL 928 

Cincinnati, OH 155 

Cleveland, OH 392 

Columbus, OH 429 

Corpus Christi, TX 182 

Dallas, TX 1,186 

Dayton, OH 36 

Denver, CO 655 

Des Moines, IA 144 

Detroit, MI 1,051 

El Paso, TX 216 

Fort Worth, TX 278 

Honolulu, HI 229 

Houston, TX 677 

Indianapolis, IN 1,096 

Jacksonville, FL 591 

Jersey City, NJ 19 

Kansas City, MO 275 

Los Angeles, CA 4,383 

Louisville, KY 416 

Memphis, TN 1,047 

Miami, FL 500 

Milwaukee, WI 994 

Minneapolis, MN 485 

Nashville, TN 537 

New Orleans, LA 547 

174 

3,013 

247 

365 

459 

184 

1,831 

54 

645 

137 

759 

176 

434 

252 

1,430 

1,013 

649 

16 

307 

5,373 

349 

919 

695 

1,070 

763 

512 

603 

300 

1,529 

688 

463 

812 

188 

2,156 

198 

676 

162 

860 

273 

763 

355 

1,648 

1,112 

544 

21 

320 

5,230 

260 

1,005 

685 

1,532 

793 

555 

757 

296 

3,443 

552 

469 

1,053 

158 

2,156 

415 

898 

262 

1,410 

296 

778 

515 

1,634 

1,157 

612 

43 

325 

6,020 

307 

1,005 

717 

1,556 

828 

574 

857 

375 

3,314 

748 

748 

1,071 

233 

2,151 

302 

974 

286 

2,273 

343 

888 

683 

1,971 

1,604 

692 

19 

365 

8,000 

352 

1,024 

583 

1,935 

893 

645 

1,045 

35.1

65.9

38.2

59.6

87.8

117.9

120.8

13.3

271.5

85.0

202.4

64.9

43.3

52.3

43.7

282.4

168.3

18.0

129.3

103.3

130.9

253.7

51.0

227.5

260.3

211.7

248.6

58.8 98.8 94.9 120.2

214.2 106.8 240.5 231.5

61.1 171.5 138.9 188.2

55.9 71.3 72.8 116.1

93.5 165.2 213.0 216.6

118.1 122.3 103.1 152.0

183.7 213.9 212.6 212.1

20.0 74.1 153.5 111.7

265.9 278.3 369.1 400.3

80.6 94.1 150.1 163.9

146.9 144.0 237.6 383.1

51.7 81.1 88.4 102.4

66.3 114.0 113.8 129.9

57.7 81.4 119.5 158.5

91.0 103.7 101.4 122.3

261.2 287.3 300.1 416.1

182.9 153.0 171.8 194.3

15.1 19.8 40.8 18.0

143.7 148.8 151.1 169.7

125.8 122.4 139.1 184.9

109.8 81.9 96.6 110.8

222.5 243.4 242.3 246.8

70.7 66.7 69.2 56.3

247.3 354.1 363.1 451.6

409.4 448.5 466.2 502.8

201.6 219.2 228.3 256.5

277.1 351.3 401.4 489.5

New York City, NY 2,080 2,762 2,669 2,846 3,377 60.2 79.7 76.5 81.4 96.6†

Newark, NJ 56 

Norfolk, VA 96 

Oakland, CA 582 

Oklahoma City, OK 267 

Omaha, NE 213 

Philadelphia, PA 635 

Phoenix, AZ 1,405 

Pittsburgh, PA 430 

Portland, OR 527 

Richmond, VA 201 

52 

84 

704 

121 

237 

1,180 

1,516 

463 

596 

234 

93 

128 

698 

423 

270 

1,581 

1,896 

565 

675 

167 

194 

125 

759 

319 

370 

2,181 

1,873 

499 

639 

259 

234 

129 

1,075 

374 

416 

2,860 

1,792 

487 

709 

329 

41.3

80.2

95.2

126.1

100.6

92.8

108.7

70.9

220.1

231.8

38.5 69.0 144.5 174.3

71.2 121.0 107.2 110.7

114.0 110.7 118.9 168.4

56.9 216.2 161.9 189.9

111.1 126.2 171.8 193.2

175.1 237.5 332.1 435.5

113.6 137.9 132.4 126.7

77.0 95.1 84.8 82.7

247.4 277.1 261.4 290.0

268.0 191.0 303.1 385.1

Rochester, NY NR NR NR NR 29 . . . . 25.1†

Sacramento, CA 714 

San Antonio, TX 563 

San Diego, CA 1,304 

San Francisco, CA 495 

San Jose, CA 538 

Seattle, WA 877 

St Louis, MO 192 

St Paul, MN 272 

St Petersburg, FL 309 

Tampa, FL 376 

Toledo, OH 63 

Tucson, AZ 405 

Tulsa, OK 288 

Washington, DC 234 

Wichita, KS 208 

725 

745 

1,477 

817 

607 

895 

211 

282 

303 

465 

44 

378 

171 

411 

244 

907 

1,048 

1,583 

1,075 

717 

1,056 

291 

336 

294 

353 

144 

311 

315 

460 

196 

987 

1,032 

1,704 

1,177 

761 

1,295 

354 

377 

314 

377 

222 

377 

305 

316 

314 

1,171 

1,096 

2,072 

1,274 

937 

1,489 

349 

485 

323 

395 

288 

375 

285 

405 

323 

131.2

88.4

96.5

137.2

67.0

109.8

120.5

205.9

76.1

86.1

29.1

107.5

156.1

92.7

97.9

132.0 161.7 169.9 201.5

115.3 160.8 155.8 165.5

107.5 113.8 119.9 145.8

226.2 291.1 318.2 344.4

74.7 86.7 91.6 112.8

110.6 129.5 157.7 181.4

135.1 187.1 231.3 228.0

212.7 259.8 291.3 374.7

74.2 71.2 76.0 78.1

104.7 78.4 82.4 86.3

20.4 67.2 104.1 135.1

98.6 80.5 96.0 95.5

91.6 171.8 164.7 153.9

165.6 187.7 130.0 166.7

113.3 89.5 142.1 146.1

Yonkers, NY NR NR NR NR 52 . . . . 56.0†

U.S. CITY TOTAL1 33,460 40,855 45,534 51,712 61,452

San Juan, PR 235 159 170 116 205 

TOTAL 33,695 41,014 45,704 51,828 61,657

100.6 122.1 134.8 152.1 178.8

59.9 40.5 33.8 23.0 40.6

100.1 121.1 133.4 150.2 176.8

†New York City has been reporting chlamydia cases since 1984. However, the State of New York, with the exception of New York City, initiated

chlamydia reporting during the year 2000. As a result, the number of chlamydia cases reported by the state of New York (including the cities of

Buffalo, Rochester and Yonkers) may be incomplete and the rate for New York State is underestimated. See Appendix.

*NR = No report (see Appendix). 1

Rates exclude population of cities that did not report.

STD Surveillance 2000 Chlamydia Tables 89 
Table 11A. Chlamydia — Reported cases by age, gender, and race/ethnicity: United States, 1996–2000 

Age 

Group 

Total 

Total Male Female 

White, Non-Hispanic 

Total Male Female 

Black, Non-Hispanic 

Total Male Female Total 

Hispanic 

Male Female 

Asian/Pacific Islander 

Total Male Female 

American Indian/ 

Alaska Native 

Total Male Female 

10-14 9,355 459 8,896 2,635 86 2,550 4,917 254 4,663 1,472 89 1,382 119 14 104 212 16 197 

15-19 151,456 16,909 134,547 52,082 4,080 48,002 69,545 9,242 60,303 24,582 2,964 21,618 1,883 209 1,674 3,364 414 2,950 

20-24 119,743 21,038 98,704 40,855 6,014 34,841 50,134 10,267 39,867 23,650 3,965 19,685 2,175 333 1,842 2,929 459 2,469 

199625-29 

30-34 

35-39 

47,061 10,428 36,633 

19,692 5,168 14,524 

9,328 2,617 6,711 

14,579 3,019 11,560 

5,808 1,508 4,300 

2,971 824 2,147 

18,956 4,865 14,091 

7,818 2,422 5,396 

3,730 1,230 2,500 

11,153 

4,860 

1,992 

2,106 

981 

449 

9,048 

3,879 

1,543 

1,071 190 881 

526 112 414 

278 61 217 

1,302 250 1,053 

679 145 535 

358 54 304 

40-44 4,067 1,269 2,798 1,306 389 917 1,630 591 1,039 836 221 614 128 39 90 167 29 138 

45-54 2,583 933 1,650 940 348 593 991 432 560 469 118 351 84 22 62 99 14 85 

55-64 515 237 279 199 83 115 189 110 79 88 32 56 12 4 8 28 7 21 

65+ 472 116 357 188 59 129 151 34 117 107 15 92 10 4 6 16 4 12 

TOTAL 366,842 59,784 307,058 122,446 16,595 105,851 159,046 29,696 129,350 69,770 11,097 58,672 6,351 992 5,359 9,229 1,404 7,825 

10-14 8,878 430 8,448 2,594 70 2,524 4,411 223 4,188 1,515 120 1,395 118 9 109 239 8 231 

15-19 155,113 18,968 136,144 52,445 4,311 48,134 70,157 10,259 59,898 27,162 3,825 23,337 2,201 271 1,930 3,147 302 2,846 

20-24 127,708 25,139 102,569 41,541 6,614 34,927 54,570 12,699 41,871 26,489 5,051 21,438 2,368 417 1,951 2,741 359 2,382 

199725-29 

30-34 

35-39 

50,324 12,558 37,766 

20,657 6,250 14,406 

9,575 3,239 6,335 

14,884 3,248 11,636 

5,750 1,588 4,162 

2,871 867 2,004 

20,612 6,246 14,366 

8,288 3,136 5,152 

3,845 1,619 2,225 

12,432 

5,435 

2,244 

2,664 

1,293 

635 

9,768 

4,142 

1,609 

1,162 236 926 

564 142 423 

312 56 257 

1,234 164 1,070 

619 92 528 

303 62 241 

40-44 4,109 1,519 2,590 1,296 435 861 1,621 776 846 910 259 652 151 33 118 130 15 114 

45-54 2,589 1,111 1,479 856 367 489 972 520 452 568 174 394 113 38 75 81 11 70 

55-64 543 268 275 173 78 95 215 123 92 117 54 63 16 3 13 23 10 13 

65+ 1,083 258 825 360 69 291 462 132 330 208 50 158 17 5 12 36 2 33 

TOTAL 382,244 70,265 311,979 123,271 17,787 105,484 165,843 35,955 129,887 77,480 14,271 63,210 7,061 1,221 5,839 8,589 1,031 7,558 

10-14 11,201 616 10,584 2,962 89 2,872 6,176 376 5,800 1,637 128 1,510 137 11 127 288 13 275 

15-19 198,916 24,326 174,590 63,623 5,200 58,422 97,745 13,937 83,807 30,538 4,375 26,162 3,007 360 2,646 4,004 453 3,551 

20-24 164,738 31,655 133,083 50,641 8,188 42,453 77,565 16,461 61,104 30,160 6,001 24,159 3,103 523 2,580 3,270 482 2,787 

199825-29 

30-34 

35-39 

64,270 15,967 48,303 

25,554 7,703 17,851 

12,558 4,364 8,194 

17,491 3,933 13,558 

6,605 2,023 4,582 

3,368 1,074 2,294 

29,649 8,357 21,293 

11,529 3,958 7,571 

5,781 2,376 3,405 

14,127 

5,958 

2,596 

3,152 

1,482 

709 

10,975 

4,476 

1,887 

1,626 334 1,292 

739 152 587 

433 124 309 

1,377 191 1,186 

723 88 634 

379 81 298 

40-44 5,293 2,027 3,266 1,520 569 951 2,419 1,134 1,285 974 247 727 201 41 160 179 36 143 

45-54 3,172 1,340 1,832 996 430 566 1,405 725 680 534 135 399 111 37 74 126 13 113 

55-64 661 305 356 171 82 89 320 174 147 116 34 82 29 9 20 24 6 18 

65+ 1,032 246 786 299 86 213 550 119 430 147 36 111 22 5 17 15 0 15 

TOTAL 489,272 89,095 400,177 148,166 21,829 126,337 234,043 47,864 186,179 87,191 16,422 70,769 9,439 1,604 7,835 10,432 1,376 9,057 

10-14 12,553 752 11,801 3,180 114 3,066 7,050 449 6,601 1,885 163 1,721 159 12 147 279 13 266 

15-19 232,371 29,729 202,642 72,646 6,302 66,344 116,288 17,280 99,008 35,453 5,184 30,270 3,601 447 3,154 4,382 516 3,867 

20-24 201,724 39,031 162,693 61,458 10,419 51,039 96,751 20,597 76,154 36,101 6,894 29,207 3,878 629 3,250 3,536 492 3,044 

25-29 

30-34 

35-39

1999

77,062 19,368 57,694 

30,337 9,169 21,169 

14,823 5,311 9,511 

20,235 4,670 15,564 

7,426 2,256 5,170 

3,926 1,397 2,528 

36,132 10,266 25,867 

13,978 4,832 9,147 

6,773 2,887 3,886 

17,024 

7,315 

3,264 

3,704 

1,741 

823 

13,320 

5,575 

2,441 

2,084 473 1,611 

929 205 724 

470 121 349 

1,587 256 1,331 

688 135 553 

389 83 307 

40-44 6,456 2,683 3,774 1,833 775 1,058 2,916 1,448 1,468 1,261 341 920 246 77 169 200 41 159 

45-54 3,947 1,804 2,143 1,097 517 580 1,745 968 777 787 228 560 171 60 110 146 30 116 

55-64 818 416 402 239 152 87 373 194 179 129 44 85 42 11 31 34 15 20 

65+ 775 264 511 255 98 157 300 104 196 113 24 88 28 15 13 80 23 57 

TOTAL 582,820 109,121 473,699 172,808 26,855 145,952 283,358 59,332 224,026 103,662 19,263 84,400 11,647 2,062 9,585 11,344 1,609 9,736 

10-14 13,068 864 12,203 3,137 109 3,028 7,420 536 6,884 2,042 194 1,848 180 13 167 288 12 276 

15-19 240,152 32,293 207,859 74,579 6,958 67,621 117,599 18,276 99,323 39,485 5,980 33,505 3,861 484 3,377 4,629 596 4,033 

20-24 223,906 45,238 178,668 67,844 12,094 55,751 103,948 22,969 80,979 43,476 8,730 34,745 4,374 819 3,555 4,263 626 3,637 

200025-29 

30-34 

35-39 

83,641 21,936 61,705 

34,559 10,813 23,746 

16,552 6,015 10,538 

21,650 5,266 16,384 

8,376 2,518 5,858 

4,241 1,618 2,623 

37,504 11,135 26,369 

15,020 5,611 9,409 

7,409 3,099 4,310 

20,591 

9,154 

3,775 

4,687 

2,233 

1,022 

15,904 

6,920 

2,753 

2,115 534 1,580 

1,139 269 870 

631 172 460 

1,781 313 1,469 

870 181 689 

497 104 392 

40-44 7,386 2,986 4,400 2,087 860 1,226 3,229 1,509 1,720 1,542 467 1,074 283 92 190 246 57 189 

45-54 4,827 2,233 2,594 1,382 688 694 2,064 1,138 926 968 280 688 230 85 145 182 41 141 

55-64 937 442 495 313 167 146 372 193 178 153 46 107 54 22 32 45 14 31 

65+ 854 306 548 295 114 181 378 130 247 137 39 98 31 21 10 14 2 12 

TOTAL 627,701 123,663 504,038 184,338 30,513 153,825 295,896 64,857 231,039 121,702 23,809 97,892 12,916 2,518 10,397 12,850 1,965 10,885 

NOTE: These tables should be used only for race/ethnicity and age comparisons, not for overall totals or gender totals. This is because, if age or race/ethnicity was not specified, cases were prorated according to the distribution of cases for which these variables were specified. For the following years the 

states listed did not report race/ethnicity for most cases and were excluded: 1996 (CO, DE, GA, MD, MI, NJ, NY, OH and SC); 1997 (CO, DE, DC, GA, MD, 

MI, MS, NJ, NY, OH and SC); 1998 (CO, DC, MI, NJ, NY, OH and SC); 1999 (CO, DC, MI, NJ and NY); 2000 (CO, DC, MI, and NY). Cases and population 

denominators have been excluded for these states/areas. Differences between total cases from this table and others in the report are due to different reporting forms and above listed exclusions. The 0 to 9 year age group is not shown because some of these may not be due to sexual transmission; however, 

they are included in the totals. 

90 Chlamydia Tables STD Surveillance 2000 
Table 11B. Chlamydia — Reported rates per 100,000 population by age, gender, and race/ethnicity: United 

States, 1996–2000 

Age 

Group Total 

Total 

Male Female 

White, Non-Hispanic 

Total Male Female 

Black, Non-Hispanic 

Total Male Female Total 

Hispanic 

Male Female 

Asian/Pacific Islander 

Total Male Female 

American Indian/ 

Alaska Native 

Total Male Female 

10-14 65.6 6.3 128.0 27.4 1.7 54.6 267.7 27.2 515.6 71.3 8.4 137.5 21.2 5.1 37.9 117.0 17.2 219.1 

15-19 1,080.8 233.8 1,984.0 553.9 84.3 1,052.1 3,776.7 987.6 6,659.1 1,176.5 266.7 2,210.3 363.7 79.5 656.1 2,087.0 510.4 3,686.4 

20-24 908.6 310.2 1,543.1 467.8 134.9 815.1 3,078.7 1,269.3 4,864.7 1,121.3 342.2 2,071.1 382.2 116.3 651.0 2,105.8 654.7 3,583.5 

25-29 

30-34 

35-39 

333.0 

125.1 

56.0 

146.4 

65.5 

31.4 

522.6 

184.8 

80.6 

151.3 62.7 239.6 

52.3 27.2 77.4 

24.2 13.4 35.2 

1,190.1 637.0 1,699.6 

459.4 301.8 600.2 

213.7 149.3 271.1 

525.4 

224.5 

104.5 

180.2 

84.4 

44.6 

947.7 

386.9 

171.3 

167.1 61.9 263.4 

82.9 36.9 124.9 

44.7 20.5 66.6 

953.0 358.3 1,571.5 

1996

497.0 213.6 775.3 

263.3 81.5 436.5 

40-44 26.4 16.5 36.1 11.2 6.7 15.8 106.1 82.0 127.3 54.7 28.1 83.0 22.1 14.3 28.9 136.5 49.4 217.0 

45-54 10.8 8.0 13.6 5.0 3.7 6.2 47.9 45.8 49.8 23.7 12.0 35.4 10.0 5.7 13.7 55.6 16.1 92.1 

55-64 3.3 3.1 3.4 1.6 1.4 1.7 14.3 19.1 10.6 7.6 5.8 9.1 2.5 1.9 3.0 26.0 14.3 36.2 

65+ 1.9 1.1 2.4 0.9 0.7 1.0 8.6 5.0 10.9 8.2 2.8 12.3 1.8 1.6 2.0 13.6 7.4 18.1 

TOTAL 185.7 61.7 305.2 84.9 23.5 143.6 764.2 299.7 1,186.3 297.1 91.5 516.8 88.4 28.7 143.9 528.4 163.6 880.7 

10-14 63.0 6.0 123.1 27.4 1.4 54.7 253.3 25.2 488.7 71.6 11.1 135.4 20.9 3.1 39.4 131.2 8.4 257.3 

15-19 1,099.7 260.5 1,995.0 553.7 88.4 1,047.3 3,985.3 1,144.2 6,934.2 1,252.8 331.8 2,298.7 407.3 99.2 723.3 1,900.2 363.5 3,445.5 

20-24 987.3 377.1 1,636.4 486.1 151.3 836.7 3,566.4 1,666.2 5,452.0 1,223.0 426.0 2,187.1 426.7 149.9 704.6 1,987.2 517.0 3,477.0 

25-29 

30-34 

35-39 

364.4 

137.1 

58.1 

180.3 

82.9 

39.3 

551.7 

191.5 

77.1 

158.8 69.4 248.0 

54.7 30.3 79.0 

23.8 14.3 33.3 

1,375.4 866.2 1,847.6 

526.4 421.5 620.5 

232.5 207.0 255.3 

580.9 

246.5 

113.0 

226.4 

108.9 

60.5 

1,013.8 

406.9 

171.8 

176.4 75.2 268.5 

88.1 46.7 125.4 

49.4 18.4 77.8 

894.0 232.0 1,587.5 

1997

465.3 138.7 787.7 

222.0 92.7 346.1 

40-44 26.3 19.5 33.1 11.0 7.4 14.7 107.7 109.4 106.2 56.2 30.9 83.4 25.2 11.8 36.9 104.1 25.8 176.7 

45-54 10.6 9.3 11.9 4.5 3.9 5.0 47.6 55.7 40.7 27.0 16.6 37.4 12.7 9.3 15.7 44.3 13.0 73.2 

55-64 3.4 3.5 3.3 1.3 1.3 1.4 16.9 22.1 12.8 9.8 9.5 10.0 3.1 1.2 4.6 21.1 20.0 22.1 

65+ 4.3 2.5 5.6 1.7 0.8 2.3 28.1 20.3 33.1 15.4 8.6 20.4 3.0 2.1 3.6 29.2 4.8 47.1 

TOTAL 194.8 72.9 312.4 86.2 25.4 144.4 840.3 381.9 1,258.4 318.6 113.6 537.8 95.6 34.4 152.3 488.6 119.3 845.5 

10-14 72.9 7.8 141.2 29.2 1.7 58.2 284.0 34.0 541.7 72.9 11.1 137.5 22.3 3.3 42.2 154.1 13.9 298.6 

15-19 1,269.9 301.7 2,297.0 615.2 97.6 1,165.3 4,401.8 1,233.8 7,682.3 1,319.4 362.3 2,364.0 491.6 116.4 876.5 2,282.1 515.4 4,055.0 

20-24 1,162.6 437.4 1,919.4 544.4 171.8 935.9 4,041.9 1,731.7 6,309.2 1,355.3 517.6 2,266.2 534.3 181.2 883.6 2,288.9 672.7 3,916.8 

25-29 

30-34 

35-39 

434.2 

159.9 

70.1 

216.1 

97.0 

48.9 

651.4 

222.1 

91.2 

176.2 79.2 273.4 

60.3 37.0 83.5 

26.1 16.6 35.7 

1,580.9 932.5 2,174.4 

591.6 433.8 730.6 

278.5 244.1 309.0 

653.8 

267.2 

124.4 

279.6 

127.3 

65.7 

1,061.6 

420.3 

187.6 

233.7 103.3 346.9 

104.6 46.2 155.4 

61.0 36.7 83.0 

959.3 260.5 1,689.0 

1998

537.0 131.4 941.8 

270.2 117.4 419.0 

40-44 30.5 23.5 37.5 11.8 8.8 14.8 125.0 125.0 125.1 56.6 28.2 86.0 30.0 13.1 45.0 136.7 56.4 211.9 

45-54 11.6 10.0 13.2 4.7 4.1 5.3 52.9 59.8 47.1 23.7 12.2 34.8 11.2 8.1 13.8 64.9 13.9 111.9 

55-64 3.7 3.6 3.8 1.2 1.2 1.2 20.1 25.1 16.3 9.0 5.6 12.0 5.1 3.5 6.5 21.0 11.3 29.5 

65+ 3.8 2.2 4.9 1.3 0.9 1.6 27.2 15.0 35.1 10.1 5.7 13.3 3.5 1.9 4.7 11.2 0.0 19.4 

TOTAL 227.9 84.8 365.3 95.9 28.8 160.3 947.0 407.4 1,436.0 341.7 127.1 561.8 116.6 41.4 185.8 572.8 153.7 977.8 

10-14 75.1 8.8 144.8 28.8 2.0 57.0 286.7 36.0 545.4 79.8 13.5 149.0 24.7 3.6 47.0 144.3 13.3 279.4 

15-19 1,369.2 340.5 2,458.6 644.2 108.5 1,212.8 4,738.7 1,384.8 8,208.5 1,470.3 412.6 2,620.7 556.8 136.8 986.2 2,406.0 565.6 4,250.2 

20-24 1,302.8 494.0 2,145.8 599.7 198.5 1,020.8 4,490.1 1,933.6 6,989.3 1,548.2 567.2 2,616.0 647.4 211.3 1,077.4 2,378.2 660.2 4,104.3 

25-29 

30-34 

35-39 

495.8 

181.9 

77.7 

250.2 

110.8 

55.9 

739.6 

251.8 

99.3 

194.1 89.5 298.9 

64.8 39.5 89.9 

28.6 20.3 36.9 

1,759.2 1,046.2 2,411.4 

672.1 496.4 826.6 

297.2 270.3 320.9 

768.7 

322.1 

148.9 

324.0 

147.2 

72.6 

1,243.0 

512.0 

230.6 

296.1 144.5 427.7 

126.8 60.5 184.0 

63.5 34.4 89.8 

1,083.1 343.3 1,847.6 

1999

507.6 198.1 820.5 

273.0 117.0 426.7 

40-44 34.2 28.6 39.8 13.1 11.0 15.1 133.7 141.7 126.6 69.0 36.6 102.6 34.9 23.3 45.3 148.0 62.7 228.7 

45-54 13.0 12.2 13.9 4.7 4.4 4.9 56.6 68.9 46.3 32.5 19.1 45.5 15.8 12.1 19.1 71.4 30.6 109.0 

55-64 4.1 4.4 3.9 1.5 2.0 1.1 20.6 24.7 17.5 9.4 6.8 11.6 7.0 4.1 9.6 28.3 25.5 30.7 

65+ 2.6 2.2 3.0 1.0 1.0 1.1 13.3 11.6 14.3 7.3 3.7 10.0 4.3 5.5 3.4 58.8 39.3 73.0 

TOTAL 251.3 96.1 400.1 103.3 32.8 171.0 1,030.7 454.4 1,552.1 387.8 142.6 638.4 137.2 50.8 216.5 605.2 174.6 1,021.3 

10-14 75.7 9.8 144.9 27.5 1.9 54.6 291.1 41.4 548.8 83.5 15.5 154.6 26.7 3.8 51.0 147.9 11.9 288.2 

15-19 1,373.0 358.9 2,447.0 643.0 116.5 1,202.0 4,631.2 1,415.3 7,959.1 1,584.9 460.9 2,806.4 569.0 141.0 1,006.5 2,527.6 650.6 4,409.2 

20-24 1,403.6 555.8 2,286.9 644.2 224.2 1,085.1 4,657.5 2,080.7 7,179.6 1,803.2 695.6 3,005.9 697.5 263.3 1,124.8 2,849.0 834.8 4,870.7 

25-29 

30-34 

35-39 

521.6 

199.8 

83.6 

274.6 

126.1 

61.0 

766.6 

272.4 

106.0 

201.9 98.1 305.9 

70.7 42.6 98.5 

29.8 22.7 37.0 

1,758.8 1,092.2 2,369.6 

692.9 552.9 816.1 

311.9 278.3 341.6 

897.0 

386.9 

164.9 

396.3 

181.7 

86.5 

1,429.2 

608.9 

248.7 

286.7 156.1 400.0 

147.0 75.1 208.8 

80.3 45.9 111.5 

1,206.8 417.0 2,022.8 

2000

636.6 263.3 1,014.3 

345.1 146.2 541.3 

40-44 37.8 30.7 44.7 14.4 11.8 16.9 142.4 142.1 142.7 80.8 48.1 114.6 37.8 26.3 48.1 180.7 86.3 270.0 

45-54 15.4 14.5 16.2 5.7 5.7 5.7 64.3 77.9 53.0 38.2 22.4 53.4 20.2 16.2 23.7 88.3 41.6 131.3 

55-64 4.6 4.5 4.6 1.9 2.1 1.7 19.6 23.5 16.6 10.6 6.8 13.9 8.6 7.5 9.5 36.4 24.6 46.8 

65+ 2.8 2.4 3.1 1.1 1.1 1.2 16.1 14.1 17.3 8.5 5.7 10.7 4.5 7.4 2.4 10.3 3.7 15.1 

TOTAL 261.5 105.3 411.1 106.6 36.0 174.3 1,035.5 477.9 1,539.8 438.4 169.9 712.3 144.5 58.8 223.1 680.2 211.6 1,133.2 

NOTE: These tables should be used only for race/ethnicity and age comparisons, not for overall totals or gender totals. This is because, if age or 

race/ethnicity was not specified, cases were prorated according to the distribution of cases for which these variables were specified. For the following 

years the states listed did not report race/ethnicity for most cases and were excluded: 1996 (CO, DE, GA, MD, MI, NJ, NY, OH and SC); 1997 (CO, DE, 

DC, GA, MD, MI, MS, NJ, NY, OH and SC); 1998 (CO, DC, MI, NJ, NY, OH and SC); 1999 (CO, DC, MI, NJ and NY); 2000 (CO, DC, MI, and NY). 

Cases and population denominators have been excluded for these states/areas. Differences between total cases from this table and others in the report 

are due to different reporting forms and above listed exclusions. The 0 to 9 year age group is not shown because some of these may not be due to sexual transmission; however, they are included in the totals. 

STD Surveillance 2000 Chlamydia Tables 91 
Table 12. Gonorrhea — Reported cases and rates by state/area, ranked by rates: United States and outlying 

areas, 2000 

Rank State/Area Cases Rate per 100,000 Population 

1 Mississippi 9,217 332.9 

2 Louisiana 13,245 302.9 

3 Alabama 12,063 276.0 

4 Georgia 20,265 260.2 

5 North Carolina 17,823 233.0 

6 Delaware 1,735 230.2 

7 Tennessee 11,876 216.6 

8 South Carolina 8,383 215.7 

9 Maryland 9,837 190.2 

10 Michigan 18,182 184.3 

11 Ohio 19,303 171.5 

12 Illinois 20,671 170.4 

13 Texas 32,919 164.2 

14 Missouri 8,883 162.4 

15 Florida 22,781 150.8 

16 Virginia 10,175 148.0 

17 Arkansas 3,642 142.7 

18 Wisconsin 7,013 133.6 

U.S. TOTAL1 358,995 131.6 

19 Oklahoma 4,229 125.9 

20 Pennsylvania 13,607 113.4 

21 New York 20,114 110.5 

22 Indiana 6,525 109.8 

23 Kansas 2,795 105.3 

24 Nebraska 1,534 92.1 

25 New Jersey 7,232 88.8 

26 Connecticut 2,912 88.7 

27 Kentucky 3,502 88.4 

28 Arizona 4,130 86.4 

29 Nevada 1,553 85.8 

30 Colorado 3,112 76.7 

31 Rhode Island 661 66.7 

32 Minnesota 3,160 66.2 

33 New Mexico 1,152 66.2 

34 California 21,619 65.2 

35 Alaska 361 58.3 

36 Massachusetts 3,045 49.3 

37 Iowa 1,392 48.5 

38 Washington 2,418 42.0 

39 Hawaii 483 40.7 

40 Guam 62 37.9 

41 South Dakota 277 37.8 

42 West Virginia 645 35.7 

43 Oregon 1,038 31.3 

44 Virgin Islands 24 21.3 

YEAR 2010 OBJECTIVE 19.0 

45 Puerto Rico 527 13.5 

46 North Dakota 73 11.5 

47 Wyoming 53 11.1 

48 Vermont 65 10.9 

49 Utah 231 10.8 

50 New Hampshire 110 9.2 

51 Idaho 98 7.8 

52 Maine 90 7.2 

53 Montana 60 6.8 

1

Includes cases reported by Washington, D.C., but excludes outlying areas (Guam, Puerto Rico and Virgin Islands). 

92 Gonorrhea Tables STD Surveillance 2000 
Table 13. Gonorrhea — Reported cases and rates by state/area and region listed in alphabetical order: United 

States and outlying areas, 1996–2000 

Cases Rates per 100,000 Population 

State/Area 1996 1997 1998 1999 2000 1996 1997 1998 1999 2000 

Alabama 13,169 12,031 12,737 10,888 12,063 307.2 278.5 292.7 249.2 276.0 

Alaska 466 391 331 302 361 77.0 64.2 53.9 48.7 58.3 

Arizona 3,709 3,802 4,213 4,293 4,130 83.6 83.5 90.2 89.8 86.4 

Arkansas 5,056 4,382 3,953 3,226 3,642 201.7 173.7 155.7 126.4 142.7 

California 18,674 17,979 19,590 18,672 21,619 58.6 55.7 60.0 56.3 65.2 

Colorado 2,021 2,315 2,033 2,526 3,112 53.0 59.5 51.2 62.3 76.7 

Connecticut 3,388 3,154 3,177 3,321 2,912 103.7 96.5 97.0 101.2 88.7 

Delaware 1,456 1,273 1,556 1,662 1,735 201.3 174.0 209.3 220.6 230.2 

Florida 19,181 19,079 19,080 22,794 22,781 133.0 130.2 127.9 150.8 150.8 

Georgia 19,806 18,471 20,666 21,244 20,265 270.0 246.7 270.4 272.8 260.2 

Hawaii 497 510 506 463 483 42.0 43.0 42.4 39.1 40.7 

Idaho 98 158 182 89 98 8.3 13.1 14.8 7.1 7.8 

Illinois 17,964 18,423 21,735 23,254 20,671 151.7 154.9 180.4 191.7 170.4 

Indiana 6,638 6,155 6,307 6,092 6,525 113.9 105.0 106.9 102.5 109.8 

Iowa 1,145 1,311 1,616 1,365 1,392 40.2 46.0 56.5 47.6 48.5 

Kansas 2,044 2,075 2,622 2,665 2,795 79.3 80.0 99.7 100.4 105.3 

Kentucky 4,229 4,027 3,813 3,349 3,502 108.9 103.0 96.9 84.6 88.4 

Louisiana 9,315 10,782 12,499 13,189 13,245 214.6 247.8 286.1 301.7 302.9 

Maine 55 66 67 83 90 4.4 5.3 5.4 6.6 7.2 

Maryland 11,592 11,568 11,254 10,430 9,837 229.1 227.1 219.2 201.7 190.2 

Massachusetts 2,189 2,225 2,258 2,453 3,045 36.0 36.4 36.7 39.7 49.3 

Michigan 15,130 15,736 16,359 15,907 18,182 155.5 161.0 166.6 161.3 184.3 

Minnesota 2,697 2,417 2,708 2,830 3,160 58.0 51.6 57.3 59.3 66.2 

Mississippi 6,988 9,367 10,689 10,411 9,217 257.8 343.1 388.4 376.0 332.9 

Missouri 8,421 7,658 9,463 8,187 8,883 157.0 141.8 174.0 149.7 162.4 

Montana 38 66 55 53 60 4.3 7.5 6.2 6.0 6.8 

Nebraska 1,168 1,210 1,204 1,471 1,534 70.8 73.0 72.4 88.3 92.1 

Nevada 1,025 829 1,445 1,303 1,553 64.0 49.4 82.7 72.0 85.8 

New Hampshire 153 96 91 115 110 13.2 8.2 7.7 9.6 9.2 

New Jersey 8,721 7,566 7,858 7,852 7,232 109.0 94.0 96.8 96.4 88.8 

New Mexico 890 857 957 974 1,152 52.0 49.5 55.1 56.0 66.2 

New York 20,604 22,393 19,062 19,826 20,114 113.6 123.5 104.9 109.0 110.5 

North Carolina 18,229 16,888 19,230 19,428 17,823 249.4 227.4 254.8 253.9 233.0 

North Dakota 37 68 80 83 73 5.8 10.6 12.5 13.1 11.5 

Ohio 14,946 14,961 18,275 18,141 19,303 133.9 133.7 163.0 161.2 171.5 

Oklahoma 4,897 4,760 5,243 4,021 4,229 148.6 143.5 156.7 119.7 125.9 

Oregon 887 773 880 903 1,038 27.8 23.8 26.8 27.2 31.3 

Pennsylvania 10,803 9,967 11,719 13,295 13,607 89.7 82.9 97.6 110.8 113.4 

Rhode Island 486 422 430 601 661 49.2 42.7 43.5 60.7 66.7 

South Carolina 11,661 11,487 11,575 15,037 8,383 313.8 305.5 301.7 387.0 215.7 

South Dakota 176 172 221 192 277 23.9 23.3 29.9 26.2 37.8 

Tennessee 11,709 11,023 11,840 11,366 11,876 220.6 205.3 218.0 207.3 216.6 

Texas 23,124 26,612 32,833 32,910 32,919 121.1 136.9 166.2 164.2 164.2 

Utah 277 278 236 254 231 13.7 13.5 11.2 11.9 10.8 

Vermont 47 53 38 52 65 8.0 9.0 6.4 8.8 10.9 

Virginia 9,293 8,888 9,265 9,402 10,175 139.4 132.0 136.4 136.8 148.0 

Washington 2,020 1,956 1,948 2,132 2,418 36.6 34.9 34.2 37.0 42.0 

West Virginia 736 957 920 584 645 40.4 52.7 50.8 32.3 35.7 

Wisconsin 4,481 4,316 6,365 6,662 7,013 87.1 83.5 121.9 126.9 133.6 

Wyoming 41 54 36 43 53 8.5 11.3 7.5 9.0 11.1 

U.S. TOTAL1 326,809 326,564 355,728 359,931 358,995 123.2 122.0 131.6 132.0 131.6 

Northeast 46,446 45,942 44,700 47,598 47,836 90.2 89.1 86.4 91.8 92.3 

Midwest 74,847 74,502 86,955 86,849 89,808 120.4 119.3 138.3 137.3 142.0 

South 174,873 176,152 191,661 193,477 185,043 188.0 187.0 200.8 200.6 191.8 

West 30,643 29,968 32,412 32,007 36,308 52.4 50.5 53.8 52.3 59.4 

Guam 56 47 72 59 62 36.7 30.1 45.0 36.1 37.9 

Puerto Rico 648 526 400 321 527 17.4 13.7 10.4 8.3 13.5 

Virgin Islands 12 40 39 51 24 10.9 36.5 35.6 45.2 21.3 

OUTLYING AREAS 716 613 511 431 613 18.0 15.0 12.4 10.3 14.7 

TOTAL 327,525 327,177 356,239 360,362 359,608 121.7 120.4 129.8 130.2 129.9 

1

Includes cases reported by Washington, D.C. 

STD Surveillance 2000 Gonorrhea Tables 93 
Table 14. Gonorrhea — Women – Reported cases and rates by state/area listed in alphabetical order: United 

States and outlying areas, 1996–2000 

Cases Rates per 100,000 Population 

State/Area 1996 1997 1998 1999 2000 1996 1997 1998 1999 2000 

Alabama 6,730 5,984 6,313 5,460 5,984 302.3 266.9 278.8 240.3 263.3 

Alaska 242 230 181 153 198 84.4 79.6 62.0 52.0 67.3 

Arizona 1,690 1,625 1,730 1,760 1,754 75.5 70.8 73.3 72.9 72.7 

Arkansas 2,506 2,071 1,919 1,576 1,807 193.7 159.2 146.2 119.5 137.1 

California 8,847 8,462 9,345 8,903 9,624 55.6 52.5 57.2 53.7 58.1 

Colorado 1,028 1,224 1,055 1,271 1,544 53.4 62.4 52.7 62.1 75.5 

Connecticut 1,815 1,642 1,714 1,796 1,621 108.1 97.7 101.7 106.3 96.0 

Delaware 799 705 855 912 987 215.4 188.0 223.8 235.5 254.9 

Florida 9,409 9,513 8,923 10,960 10,862 126.9 126.3 116.2 140.9 139.6 

Georgia 9,806 9,532 10,056 10,092 9,844 260.7 248.5 256.3 252.5 246.3 

Hawaii 244 264 278 251 240 41.6 44.8 46.7 42.3 40.4 

Idaho 53 83 74 42 51 8.9 13.7 12.0 6.7 8.1 

Illinois 9,112 6,765 11,250 11,698 9,015 150.3 111.2 182.3 188.3 145.1 

Indiana 3,305 3,141 3,308 3,254 3,446 110.6 104.5 109.2 106.6 112.9 

Iowa 666 762 895 759 740 45.6 52.2 60.9 51.6 50.3 

Kansas 1,084 1,133 1,454 1,573 1,496 82.8 86.0 108.8 116.6 110.9 

Kentucky 2,013 1,882 1,866 1,626 1,725 100.9 93.7 92.1 79.8 84.7 

Louisiana 3,923 5,202 6,143 6,697 6,471 174.4 230.7 270.8 295.3 285.3 

Maine 27 31 31 40 29 4.3 4.9 4.9 6.2 4.5 

Maryland 5,692 5,767 5,391 4,749 4,577 219.2 220.6 204.2 178.6 172.2 

Massachusetts 1,146 1,151 1,155 1,207 1,568 36.4 36.4 36.3 37.8 49.0 

Michigan 7,780 7,969 8,265 7,771 9,190 155.9 159.1 164.0 153.5 181.5 

Minnesota 1,383 1,307 1,443 1,495 1,681 58.7 55.1 60.2 61.7 69.4 

Mississippi 3,681 5,188 5,973 6,137 5,603 261.3 365.7 416.8 425.6 388.6 

Missouri 4,193 4,113 4,924 4,459 4,489 151.7 147.9 175.5 158.2 159.2 

Montana 19 31 33 35 38 4.3 7.0 7.5 7.9 8.6 

Nebraska 606 670 683 814 849 72.0 79.3 80.4 95.6 99.7 

Nevada 362 317 591 480 618 46.1 38.6 68.9 54.0 69.6 

New Hampshire 95 57 47 61 53 16.1 9.6 7.8 10.0 8.7 

New Jersey 3,743 3,564 3,763 3,824 3,571 90.8 86.0 89.9 91.1 85.1 

New Mexico 459 509 530 528 573 52.9 58.0 60.1 59.7 64.8 

New York 10,952 12,833 10,586 10,639 10,691 116.5 136.6 112.2 112.9 113.4 

North Carolina 8,482 7,844 9,129 9,089 8,468 225.8 205.6 234.9 230.6 214.9 

North Dakota 18 42 56 46 36 5.6 13.1 17.5 14.4 11.3 

Ohio 8,161 8,349 10,117 9,707 10,311 141.7 144.8 174.7 166.9 177.3 

Oklahoma 2,610 2,418 2,932 2,240 2,433 155.1 142.8 171.2 130.3 141.6 

Oregon 418 348 430 433 486 25.9 21.2 25.9 25.8 29.0 

Pennsylvania 5,730 5,396 6,472 7,356 7,371 91.8 86.6 103.9 118.1 118.3 

Rhode Island 245 263 258 371 381 47.8 51.4 50.3 72.1 74.1 

South Carolina 4,807 5,128 5,730 5,874 4,057 250.2 263.9 288.3 292.1 201.8 

South Dakota 94 87 124 117 165 25.1 23.3 33.1 31.4 44.3 

Tennessee 5,106 4,940 5,263 4,965 5,343 186.3 178.2 187.3 175.0 188.3 

Texas 11,933 13,797 16,704 16,819 16,932 123.6 140.4 166.8 165.6 166.7 

Utah 95 84 70 100 99 9.4 8.1 6.6 9.3 9.2 

Vermont 23 32 22 22 33 7.7 10.7 7.3 7.3 10.9 

Virginia 4,495 4,290 4,543 4,566 4,856 132.2 124.9 130.7 129.9 138.2 

Washington 929 965 863 1,009 1,078 33.5 34.3 30.2 34.9 37.2 

West Virginia 363 512 549 357 375 38.5 54.5 58.5 38.1 40.0 

Wisconsin 2,343 2,344 3,754 3,826 4,189 89.6 89.3 141.3 143.3 156.9 

Wyoming 25 30 23 26 31 10.5 12.6 9.6 10.9 13.0 

U.S. TOTAL1 161,128 162,515 179,717 179,454 178,854 119.0 119.0 130.0 128.7 128.3 

Guam 30 12 25 28 23 41.8 16.3 33.3 36.4 29.9 

Puerto Rico 219 212 163 132 238 11.4 10.7 8.1 6.5 11.8 

Virgin Islands 4 19 16 38 14 7.0 33.3 27.8 73.7 27.1 

OUTLYING AREAS 253 243 204 198 275 12.3 11.5 9.5 9.2 12.8 

TOTAL 161,381 162,758 179,921 179,652 179,129 117.4 117.3 128.2 126.9 126.5 

1

Includes cases reported by Washington, D.C.
 

NOTE: Cases and rates underestimated in some areas because of under-reporting or non-reporting by gender.
 

94 Gonorrhea Tables STD Surveillance 2000 
Table 15. Gonorrhea — Men – Reported cases and rates by state/area listed in alphabetical order: United 

States and outlying areas, 1996–2000 

Cases Rates per 100,000 Population 

State/Area 1996 1997 1998 1999 2000 1996 1997 1998 1999 2000 

Alabama 6,409 6,022 6,411 5,399 6,039 311.0 290.0 307.1 257.4 287.9 

Alaska 224 161 150 149 163 70.4 50.3 46.6 45.8 50.1 

Arizona 2,019 2,177 2,483 2,533 2,376 91.9 96.4 107.5 107.1 100.5 

Arkansas 2,536 2,295 2,029 1,650 1,832 209.1 187.9 165.5 133.8 148.6 

California 9,729 9,452 10,192 9,618 11,896 61.0 58.5 62.4 58.0 71.8 

Colorado 992 1,091 978 1,255 1,568 52.4 56.5 49.7 62.4 78.0 

Connecticut 1,573 1,512 1,463 1,525 1,291 99.1 95.1 92.1 95.7 81.1 

Delaware 657 568 701 750 748 186.4 159.3 193.9 204.8 204.2 

Florida 9,772 9,566 10,054 11,797 11,919 139.5 134.3 138.9 160.9 162.6 

Georgia 10,000 8,916 10,525 11,039 10,309 279.8 244.2 283.1 291.2 271.9 

Hawaii 253 246 228 211 243 42.4 41.2 38.1 35.6 41.0 

Idaho 45 75 108 46 47 7.6 12.4 17.6 7.4 7.5 

Illinois 8,852 11,658 10,485 11,545 11,655 153.1 200.6 178.5 195.1 197.0 

Indiana 3,331 3,006 2,991 2,836 3,069 117.3 105.1 104.2 98.1 106.1 

Iowa 479 549 721 606 652 34.5 39.4 51.7 43.4 46.7 

Kansas 960 942 1,168 1,092 1,299 75.6 73.7 90.4 83.7 99.5 

Kentucky 2,216 2,137 1,887 1,669 1,751 117.5 112.5 98.8 86.8 91.0 

Louisiana 5,392 5,580 6,356 6,492 6,774 257.8 266.1 302.6 308.6 322.0 

Maine 28 35 36 43 61 4.6 5.8 5.9 7.0 10.0 

Maryland 5,897 5,801 5,846 5,669 5,196 239.4 233.9 234.3 225.6 206.8 

Massachusetts 1,043 1,074 1,103 1,246 1,477 35.5 36.4 37.2 41.8 49.6 

Michigan 7,350 7,767 8,094 8,136 8,992 155.0 163.0 169.5 169.5 187.3 

Minnesota 1,314 1,110 1,265 1,335 1,479 57.3 48.0 54.3 56.7 62.9 

Mississippi 3,266 4,049 4,653 4,184 3,586 250.9 308.6 352.8 315.4 270.3 

Missouri 4,228 3,545 4,539 3,728 4,394 162.6 135.2 172.4 140.7 165.8 

Montana 19 35 22 18 22 4.3 8.0 5.0 4.1 5.0 

Nebraska 553 537 520 657 681 68.5 66.1 63.9 80.6 83.6 

Nevada 663 512 854 822 935 81.2 59.9 96.1 89.2 101.5 

New Hampshire 58 39 44 54 57 10.2 6.7 7.5 9.1 9.6 

New Jersey 4,972 3,999 4,094 4,019 3,654 128.1 102.3 104.2 101.8 92.6 

New Mexico 431 348 427 445 572 51.1 40.8 50.0 52.0 66.8 

New York 9,652 9,560 8,476 9,176 9,378 110.5 109.3 96.9 104.6 106.9 

North Carolina 9,747 9,044 10,101 10,339 9,354 274.4 250.5 276.0 278.7 252.1 

North Dakota 19 26 24 37 37 5.9 8.1 7.6 11.7 11.7 

Ohio 6,672 6,506 8,023 8,245 8,837 123.5 120.1 148.1 151.5 162.4 

Oklahoma 2,287 2,342 2,311 1,781 1,796 141.9 144.3 141.4 108.6 109.5 

Oregon 469 425 450 470 552 29.7 26.5 27.8 28.7 33.7 

Pennsylvania 5,073 4,571 5,247 5,939 6,236 87.5 79.0 90.9 103.0 108.2 

Rhode Island 241 159 172 230 280 50.7 33.4 36.2 48.3 58.8 

South Carolina 6,828 6,340 5,769 9,052 4,256 380.2 349.0 312.1 482.8 227.0 

South Dakota 82 85 97 75 111 22.6 23.4 26.7 20.8 30.8 

Tennessee 6,603 6,083 6,577 6,401 6,533 257.3 234.4 251.0 241.8 246.8 

Texas 11,191 12,815 15,995 15,973 15,919 118.6 133.3 164.1 161.5 161.0 

Utah 182 194 166 154 132 18.1 18.9 15.9 14.5 12.5 

Vermont 24 21 16 30 32 8.3 7.2 5.5 10.3 11.0 

Virginia 4,783 4,590 4,720 4,832 5,307 146.4 139.2 142.3 143.9 158.0 

Washington 1,091 991 1,085 1,123 1,340 39.7 35.4 38.4 39.2 46.8 

West Virginia 373 445 369 227 269 42.5 50.8 42.3 26.1 30.9 

Wisconsin 2,138 1,972 2,611 2,827 2,817 84.5 77.5 101.7 109.6 109.2 

Wyoming 16 24 13 17 22 6.6 9.9 5.4 7.1 9.1 

U.S. TOTAL1 165,323 163,634 175,253 179,510 179,375 127.4 124.9 132.7 134.7 134.6 

Guam 26 35 47 31 39 32.1 42.3 55.5 35.8 45.0 

Puerto Rico 429 314 237 189 289 23.9 17.1 12.8 10.1 15.5 

Virgin Islands 8 21 23 13 10 15.2 39.9 43.2 21.2 16.3 

OUTLYING AREAS 463 370 307 233 338 24.0 18.8 15.4 11.6 16.8 

TOTAL 165,786 164,004 175,560 179,743 179,713 125.9 123.3 131.0 132.9 132.8 

1

Includes cases reported by Washington, D.C.
 

NOTE: Cases and rates underestimated in some areas because of under-reporting or non-reporting by gender.
 

STD Surveillance 2000 Gonorrhea Tables 95 
10

20

30

40

50

60

Table 16. Gonorrhea — Reported cases and rates in selected cities of >200,000 population, ranked by rates: 

United States and outlying areas, 2000 

Rank City Cases Rate per 100,000 Population 

1 Richmond, VA 1,752 923.6 

2 Rochester, NY 2,142 894.8 

3 Baltimore, MD 5,603 885.6 

4 St Louis, MO 2,879 862.1 

5 Detroit, MI 9,610 766.7 

6 Norfolk, VA 1,490 659.7 

7 New Orleans, LA 3,015 654.1 

8 Kansas City, MO 2,688 595.2 

9 Philadelphia, PA 8,198 578.3 

Milwaukee, WI 5,146 567.8 

11 Memphis, TN 4,941 566.0 

12 Newark, NJ 1,558 550.0 

13 Washington, DC 2,706 521.4 

14 Buffalo, NY 1,572 500.8 

15 Jacksonville, FL 3,640 492.9 

16 Atlanta, GA 3,456 464.0 

17 Birmingham, AL 3,018 459.1 

18 Nashville, TN 2,404 453.5 

19 Minneapolis, MN 1,577 430.7 

Indianapolis, IN 3,206 395.3 

21 Cincinnati, OH 3,227 384.0 

22 Chicago, IL 10,841 363.7 

23 Dallas, TX 7,315 354.7 

24 Oklahoma City, OK 1,434 349.8 

25 Columbus, OH 3,386 329.4 

26 Denver, CO 1,594 318.9 

27 San Francisco, CA 2,161 289.4 

28 Charlotte, NC 1,758 271.1 

29 Omaha, NE 1,161 260.2 

St Paul, MN 703 259.6 

31 Cleveland, OH 3,497 254.9 

32 Corpus Christi, TX 775 245.7 

33 Tulsa, OK 893 232.7 

34 Boston, MA 1,229 220.9 

35 Jersey City, NJ 465 212.9 

36 Austin, TX 1,518 208.8 

37 Fort Worth, TX 2,787 201.6 

38 Toledo, OH 864 193.5 

39 Houston, TX 5,918 182.1 

Dayton, OH 1,015 179.4 

41 Louisville, KY 1,200 178.3 

42 Tampa, FL 1,653 175.8 

43 St Petersburg, FL 1,542 175.5 

44 Akron, OH 913 169.7 

45 San Antonio, TX 2,298 167.4 

46 New York City, NY 11,669 157.1 

47 Wichita, KS 675 149.4 

48 Oakland, CA 1,793 138.6 

49 Portland, OR 681 136.3 

Albuquerque, NM 697 133.1 

51 Pittsburgh, PA 1,494 118.9 

52 Phoenix, AZ 3,195 111.7 

53 Sacramento, CA 1,295 109.3 

54 Des Moines, IA 380 104.2 

55 Miami, FL 1,995 91.7 

56 Los Angeles, CA 7,307 83.7 

57 Tucson, AZ 591 73.5 

58 Seattle, WA 1,221 73.3 

59 San Diego, CA 1,798 63.7 

Yonkers, NY 109 56.0 

61 Honolulu, HI 433 50.1 

62 El Paso, TX 209 29.8 

63 San Jose, CA 446 27.1 

64 San Juan, PR 270 25.7 

YEAR 2010 OBJECTIVE 19.0 

96 Gonorrhea Tables STD Surveillance 2000 
Table 17. Gonorrhea — Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1996–2000 

Cases 

City 1996 1997 1998 1999 2000 

Akron, OH 646 

Albuquerque, NM 560 

Atlanta, GA 5,211 

Austin, TX 1,363 

Baltimore, MD 6,495 

Birmingham, AL 3,239 

Boston, MA 821 

Buffalo, NY 1,284 

Charlotte, NC 1,823 

Chicago, IL 11,383 

Cincinnati, OH 1,442 

Cleveland, OH 3,362 

Columbus, OH 1,480 

Corpus Christi, TX 367 

Dallas, TX 5,795 

Dayton, OH 954 

Denver, CO 992 

Des Moines, IA 310 

Detroit, MI 7,048 

El Paso, TX 157 

Fort Worth, TX 1,331 

Honolulu, HI 457 

Houston, TX 5,999 

Indianapolis, IN 3,178 

Jacksonville, FL 2,352 

Jersey City, NJ 371 

Kansas City, MO 2,401 

Los Angeles, CA 5,716 

Louisville, KY 2,059 

Memphis, TN 5,242 

Miami, FL 2,317 

Milwaukee, WI 3,528 

Minneapolis, MN 1,548 

Nashville, TN 2,033 

New Orleans, LA 3,013 

New York City, NY 12,998 

Newark, NJ 2,710 

Norfolk, VA 1,451 

Oakland, CA 1,714 

Oklahoma City, OK 1,986 

Omaha, NE 877 

Philadelphia, PA 6,415 

Phoenix, AZ 2,906 

Pittsburgh, PA 1,058 

Portland, OR 564 

Richmond, VA 1,737 

Rochester, NY 2,126 

Sacramento, CA 1,393 

San Antonio, TX 1,349 

San Diego, CA 1,815 

San Francisco, CA 1,626 

San Jose, CA 481 

Seattle, WA 925 

St Louis, MO 2,890 

St Paul, MN 597 

St Petersburg, FL 1,165 

Tampa, FL 1,574 

Toledo, OH 419 

Tucson, AZ 518 

Tulsa, OK 1,284 

Washington, DC 4,432 

Wichita, KS 585 

Yonkers, NY 98 

669 

544 

5,468 

1,531 

6,693 

3,104 

939 

1,172 

1,703 

11,498 

2,552 

2,743 

2,218 

351 

6,645 

1,070 

1,140 

330 

7,518 

155 

1,759 

484 

6,606 

2,912 

2,089 

373 

1,872 

5,810 

1,817 

4,876 

2,168 

3,303 

1,430 

2,050 

2,743 

15,592 

1,967 

1,466 

1,559 

982 

813 

6,504 

3,007 

1,026 

478 

1,465 

1,867 

1,380 

1,751 

1,509 

1,510 

471 

918 

2,806 

383 

1,201 

2,246 

346 

575 

618 

4,557 

614 

79 

823 

570 

5,599 

1,803 

6,989 

3,172 

982 

1,108 

1,911 

13,959 

3,583 

3,030 

3,082 

449 

7,421 

1,092 

973 

371 

8,459 

252 

3,310 

481 

7,226 

3,071 

2,463 

491 

2,538 

5,986 

1,462 

5,235 

2,573 

4,856 

1,562 

1,777 

2,691 

12,097 

1,781 

1,415 

1,742 

1,571 

871 

7,271 

3,543 

1,351 

527 

1,527 

1,992 

1,546 

1,862 

1,595 

1,858 

453 

975 

3,652 

519 

1,468 

1,696 

655 

403 

1,308 

4,508 

466 

105 

848 

472 

5,631 

1,562 

6,124 

2,492 

900 

1,233 

1,908 

14,488 

2,814 

3,391 

3,120 

524 

7,476 

932 

1,157 

333 

7,900 

156 

2,847 

430 

5,939 

3,045 

2,972 

490 

1,956 

6,054 

1,195 

5,038 

2,775 

4,884 

1,558 

1,785 

2,687 

12,210 

1,741 

1,291 

1,700 

1,351 

1,000 

7,775 

3,586 

1,573 

540 

1,827 

2,037 

1,236 

2,087 

1,561 

1,606 

418 

922 

2,876 

545 

1,835 

1,783 

624 

415 

964 

3,536 

771 

102 

913 

697 

3,456 

1,518 

5,603 

3,018 

1,229 

1,572 

1,758 

10,841 

3,227 

3,497 

3,386 

775 

7,315 

1,015 

1,594 

380 

9,610 

209 

2,787 

433 

5,918 

3,206 

3,640 

465 

2,688 

7,307 

1,200 

4,941 

1,995 

5,146 

1,577 

2,404 

3,015 

11,669 

1,558 

1,490 

1,793 

1,434 

1,161 

8,198 

3,195 

1,494 

681 

1,752 

2,142 

1,295 

2,298 

1,798 

2,161 

446 

1,221 

2,879 

703 

1,542 

1,653 

864 

591 

893 

2,706 

675 

109 

U.S. CITY TOTAL 153,970 156,025 170,107 165,028 166,736 

San Juan, PR 343 233 227 179 270 

TOTAL 154,313 156,258 170,334 165,207 167,006 

Rates per 100,000 Population 

1996 1997 1998 1999 2000 

121.9 

106.6 

729.2 

199.9 

966.9 

490.0 

147.2 

397.7 

305.8 

389.9 

168.5 

240.6 

146.2 

116.6 

290.6 

168.7 

199.8 

87.8 

644.1 

22.9 

102.4 

52.6 

192.6 

390.0 

324.4 

171.0 

539.2 

67.2 

307.0 

606.0 

113.7 

384.2 

403.7 

381.6 

635.4 

177.2 

948.7 

623.7 

138.5 

452.6 

200.3 

435.4 

111.2 

81.9 

115.1 

909.6 

879.2 

125.0 

102.7 

67.8 

222.8 

30.3 

57.3 

827.4 

216.8 

134.2 

175.9 

92.7 

67.5 

336.6 

821.8 

135.2 

51.1 

125.8 153.1 157.7 169.7 

103.4 108.4 90.2 133.1 

756.8 757.3 756.0 464.0 

220.7 253.7 214.8 208.8 

1,018.3 1,082.6 967.9 885.6 

471.3 481.0 379.1 459.1 

168.5 176.5 161.8 220.9 

366.0 349.8 392.8 500.8 

277.7 302.9 294.3 271.1 

394.6 468.6 486.1 363.7 

299.7 422.8 334.8 384.0 

197.8 219.5 247.2 254.9 

218.0 301.8 303.6 329.4 

110.6 141.9 166.1 245.7 

328.4 361.8 362.5 354.7 

190.6 195.5 164.7 179.4 

228.5 195.0 231.5 318.9 

93.2 103.1 91.3 104.2 

690.3 671.2 630.3 766.7 

22.1 35.8 22.2 29.8 

132.5 244.2 205.9 201.6 

55.6 55.1 49.7 50.1 

209.2 225.4 182.7 182.1 

357.9 377.5 375.5 395.3 

285.1 334.8 402.4 492.9 

171.2 223.1 224.4 212.9 

418.7 561.6 433.1 595.2 

67.9 69.4 69.3 83.7 

270.9 217.5 177.6 178.3 

563.1 602.5 577.1 566.0 

106.0 119.5 127.5 91.7 

363.4 532.6 538.9 567.8 

373.0 428.5 425.5 430.7 

384.1 332.8 336.8 453.5 

584.8 578.0 583.0 654.1 

212.3 163.0 164.4 157.1 

691.2 626.3 614.7 550.0 

639.1 657.5 571.6 659.7 

124.4 136.1 131.4 138.6 

222.9 385.4 329.6 349.8 

184.4 196.3 224.1 260.2 

448.1 506.2 548.5 578.3 

111.5 127.3 125.3 111.7 

80.1 106.5 125.2 118.9 

97.0 105.8 108.1 136.3 

761.5 786.4 963.1 923.6 

774.1 827.9 851.0 894.8 

122.6 135.1 104.3 109.3 

131.4 137.6 152.0 167.4 

55.4 57.4 55.3 63.7 

206.2 249.1 215.1 289.4 

29.3 27.6 25.4 27.1 

56.2 58.9 55.4 73.3 

820.8 1,076.3 861.2 862.1 

138.7 191.9 201.2 259.6 

137.8 167.2 208.9 175.5 

247.0 183.3 189.6 175.8 

76.7 146.0 139.8 193.5 

73.7 51.0 51.6 73.5 

160.2 343.8 251.2 232.7 

861.5 861.7 681.3 521.4 

140.0 104.0 170.7 149.4 

41.0 54.4 52.4 56.0 

222.2 223.9 241.2 232.5 234.9 

39.3 26.7 21.7 17.0 25.7 

220.0 221.5 238.0 229.4 231.9 

STD Surveillance 2000 Gonorrhea Tables 97 
Table 18. Gonorrhea — Women – Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1996–2000 

Cases 

City 1996 1997 1998 1999 2000 

Akron, OH 366 

Albuquerque, NM 261 

Atlanta, GA 2,437 

Austin, TX 714 

Baltimore, MD 3,054 

Birmingham, AL 1,668 

Boston, MA 405 

Buffalo, NY 772 

Charlotte, NC 737 

Chicago, IL 5,710 

Cincinnati, OH 1,007 

Cleveland, OH 1,881 

Columbus, OH 797 

Corpus Christi, TX 192 

Dallas, TX 3,121 

Dayton, OH 458 

Denver, CO 474 

Des Moines, IA 169 

Detroit, MI 3,312 

El Paso, TX 75 

Fort Worth, TX 748 

Honolulu, HI 223 

Houston, TX 2,636 

Indianapolis, IN 1,550 

Jacksonville, FL 1,129 

Jersey City, NJ 175 

Kansas City, MO 1,212 

Los Angeles, CA 2,612 

Louisville, KY 889 

Memphis, TN 2,303 

Miami, FL 1,048 

Milwaukee, WI 1,832 

Minneapolis, MN 740 

Nashville, TN 779 

New Orleans, LA 1,216 

New York City, NY 6,788 

Newark, NJ 998 

Norfolk, VA 614 

Oakland, CA 1,004 

Oklahoma City, OK 1,010 

Omaha, NE 462 

Philadelphia, PA 3,387 

Phoenix, AZ 1,243 

Pittsburgh, PA 574 

Portland, OR 272 

Richmond, VA 817 

Rochester, NY 1,107 

Sacramento, CA 736 

San Antonio, TX 708 

San Diego, CA 883 

San Francisco, CA 390 

San Jose, CA 254 

Seattle, WA 349 

St Louis, MO 1,302 

St Paul, MN 314 

St Petersburg, FL 619 

Tampa, FL 752 

Toledo, OH 221 

Tucson, AZ 283 

Tulsa, OK 670 

Washington, DC 1,841 

Wichita, KS 301 

Yonkers, NY 54 

356 

306 

2,544 

860 

3,279 

1,567 

445 

720 

644 

3,087 

1,515 

1,573 

1,214 

163 

3,319 

502 

577 

160 

3,583 

76 

1,014 

252 

3,082 

1,401 

1,009 

204 

1,072 

2,645 

745 

2,175 

987 

1,707 

737 

845 

1,226 

9,101 

848 

636 

901 

503 

456 

3,507 

1,209 

543 

203 

650 

959 

765 

955 

660 

298 

205 

403 

1,409 

203 

648 

1,214 

162 

285 

299 

1,919 

321 

35 

435 

308 

2,462 

894 

3,258 

1,555 

477 

682 

830 

7,022 

2,044 

1,672 

1,584 

181 

3,591 

490 

463 

189 

4,147 

123 

1,743 

262 

3,285 

1,532 

898 

231 

1,382 

2,792 

624 

2,259 

1,053 

2,862 

806 

718 

1,158 

6,791 

794 

593 

987 

839 

494 

3,938 

1,415 

788 

246 

752 

1,031 

869 

1,012 

688 

402 

224 

324 

1,685 

278 

738 

886 

350 

175 

728 

1,904 

243 

55 

413 

234 

2,443 

768 

2,702 

1,229 

410 

725 

754 

7,041 

1,600 

1,779 

1,575 

224 

3,616 

393 

515 

161 

3,706 

78 

1,405 

231 

2,699 

1,601 

1,238 

228 

1,045 

2,835 

494 

2,163 

1,152 

2,783 

781 

736 

1,198 

6,402 

806 

542 

950 

721 

546 

4,179 

1,434 

920 

250 

956 

1,047 

692 

1,113 

653 

381 

190 

331 

1,510 

276 

942 

942 

388 

179 

527 

1,509 

452 

73 

463 

323 

1,543 

712 

2,578 

1,552 

618 

914 

748 

3,775 

1,868 

1,697 

1,798 

355 

3,494 

430 

714 

200 

4,737 

96 

1,346 

217 

2,986 

1,516 

1,599 

211 

1,242 

3,072 

510 

2,225 

750 

3,057 

725 

1,016 

1,325 

6,051 

692 

646 

992 

839 

626 

4,288 

1,325 

826 

303 

783 

1,102 

702 

1,187 

702 

412 

174 

448 

1,426 

411 

739 

823 

487 

257 

495 

1,271 

358 

64 

U.S. CITY TOTAL 74,655 74,888 83,241 79,866 78,841 

San Juan, PR 102 83 85 73 105 

TOTAL 74,757 74,971 83,326 79,939 78,946 

Rates per 100,000 Population 

1996 1997 1998 1999 2000 

132.9 

97.2 

653.3 

209.0 

850.8 

474.4 

140.3 

458.5 

238.8 

378.1 

223.9 

254.4 

152.2 

119.7 

308.3 

155.8 

185.8 

92.0 

575.9 

21.3 

113.6 

51.7 

168.4 

363.3 

301.9 

156.7 

521.0 

61.3 

251.8 

509.2 

99.1 

380.7 

375.4 

279.1 

478.4 

175.1 

664.4 

543.6 

160.3 

444.7 

204.3 

429.2 

94.1 

83.7 

108.5 

783.7 

884.1 

129.0 

104.6 

66.6 

105.6 

32.3 

42.8 

685.7 

219.2 

133.9 

164.1 

93.8 

72.4 

340.2 

642.0 

136.6 

53.8 

128.9 155.4 147.5 165.3 

113.7 114.2 87.1 120.2 

674.9 636.8 627.6 396.4 

247.5 250.2 210.1 194.8 

933.0 945.7 800.8 764.1 

447.3 442.0 350.6 442.8 

154.3 165.4 142.4 214.6 

431.4 412.8 443.9 559.6 

203.0 253.7 224.0 222.3 

204.8 453.8 454.6 243.7 

338.6 458.0 361.2 421.7 

214.4 228.6 244.6 233.3 

230.7 299.1 295.3 337.1 

100.8 111.3 138.1 218.9 

323.4 344.4 345.1 333.4 

172.0 168.2 133.0 145.5 

225.1 180.8 200.8 278.4 

86.9 100.7 84.7 105.2 

626.0 625.4 561.5 717.7 

21.1 33.6 21.2 26.2 

150.8 254.0 201.0 192.6 

58.2 60.0 53.3 50.0 

194.3 203.1 164.7 182.2 

329.0 359.3 376.3 356.3 

267.1 236.3 323.8 418.3 

181.8 202.9 201.9 186.8 

459.3 583.5 441.8 525.1 

61.7 64.2 64.3 69.7 

211.1 176.0 139.1 143.6 

480.2 495.4 472.1 485.7 

93.0 93.5 101.1 65.8 

358.4 597.5 582.5 639.9 

374.1 429.4 414.2 384.5 

302.1 255.8 264.2 364.7 

487.5 463.1 484.2 535.5 

234.6 172.7 162.9 153.9 

566.7 530.5 541.0 464.5 

571.1 541.8 495.9 591.0 

141.7 151.9 144.9 151.3 

220.6 395.8 338.6 394.0 

200.3 215.0 236.4 271.1 

451.2 511.1 549.2 563.5 

88.8 100.4 99.1 91.6 

79.9 116.9 137.7 123.6 

80.6 96.7 98.0 118.8 

618.6 704.5 916.9 751.0 

768.4 827.4 845.9 890.4 

132.7 148.9 114.6 116.3 

139.2 144.3 156.6 167.0 

48.9 49.5 46.6 50.1 

80.3 106.8 101.1 109.3 

25.7 27.5 23.3 21.3 

48.9 38.6 39.2 53.1 

758.6 916.7 834.8 788.3 

141.4 196.9 195.2 290.6 

139.8 158.7 202.5 158.9 

260.9 186.5 195.1 170.4 

68.9 149.5 166.3 208.8 

71.8 43.3 43.6 62.6 

150.1 369.2 265.3 249.2 

683.5 684.7 546.8 460.5 

143.7 106.1 196.0 155.2 

34.8 54.3 71.7 62.8 

209.4 208.9 228.6 218.1 215.3 

21.3 17.3 15.6 13.3 19.2 

206.9 206.4 225.5 215.1 212.5 

98 Gonorrhea Tables STD Surveillance 2000 
Table 19. Gonorrhea — Men – Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1996–2000 

Cases 

City 1996 1997 1998 1999 2000 

Akron, OH 277 

Albuquerque, NM 299 

Atlanta, GA 2,774 

Austin, TX 649 

Baltimore, MD 3,441 

Birmingham, AL 1,569 

Boston, MA 416 

Buffalo, NY 512 

Charlotte, NC 1,086 

Chicago, IL 5,673 

Cincinnati, OH 432 

Cleveland, OH 1,462 

Columbus, OH 675 

Corpus Christi, TX 175 

Dallas, TX 2,674 

Dayton, OH 493 

Denver, CO 517 

Des Moines, IA 141 

Detroit, MI 3,736 

El Paso, TX 82 

Fort Worth, TX 583 

Honolulu, HI 234 

Houston, TX 3,363 

Indianapolis, IN 1,627 

Jacksonville, FL 1,223 

Jersey City, NJ 195 

Kansas City, MO 1,189 

Los Angeles, CA 3,104 

Louisville, KY 1,170 

Memphis, TN 2,939 

Miami, FL 1,269 

Milwaukee, WI 1,696 

Minneapolis, MN 808 

Nashville, TN 1,254 

New Orleans, LA 1,797 

New York City, NY 6,210 

Newark, NJ 1,712 

Norfolk, VA 834 

Oakland, CA 710 

Oklahoma City, OK 976 

Omaha, NE 406 

Philadelphia, PA 3,028 

Phoenix, AZ 1,663 

Pittsburgh, PA 484 

Portland, OR 292 

Richmond, VA 919 

Rochester, NY 1,019 

Sacramento, CA 655 

San Antonio, TX 641 

San Diego, CA 859 

San Francisco, CA 1,236 

San Jose, CA 220 

Seattle, WA 576 

St Louis, MO 1,588 

St Paul, MN 283 

St Petersburg, FL 546 

Tampa, FL 822 

Toledo, OH 196 

Tucson, AZ 235 

Tulsa, OK 614 

Washington, DC 2,591 

Wichita, KS 284 

Yonkers, NY 44 

310 

238 

2,917 

671 

3,414 

1,531 

494 

452 

1,059 

8,411 

1,023 

1,153 

997 

188 

3,326 

566 

563 

170 

3,935 

79 

745 

232 

3,524 

1,511 

1,080 

169 

800 

3,165 

1,071 

2,701 

1,181 

1,596 

693 

1,205 

1,517 

6,491 

1,119 

828 

658 

479 

355 

2,997 

1,798 

483 

275 

815 

908 

606 

796 

805 

1,212 

264 

515 

1,397 

180 

553 

1,032 

184 

290 

319 

2,637 

293 

44 

380 

262 

3,118 

905 

3,714 

1,614 

505 

426 

1,081 

6,937 

1,518 

1,347 

1,488 

268 

3,814 

601 

510 

182 

4,312 

129 

1,537 

219 

3,937 

1,539 

1,564 

260 

1,156 

3,194 

831 

2,976 

1,518 

1,994 

756 

1,059 

1,533 

5,306 

987 

822 

749 

732 

376 

3,333 

2,128 

563 

281 

775 

961 

673 

846 

883 

1,456 

227 

651 

1,967 

241 

728 

800 

305 

228 

580 

2,604 

223 

50 

429 

237 

3,172 

792 

3,410 

1,258 

490 

508 

1,154 

7,444 

1,193 

1,589 

1,523 

300 

3,834 

539 

642 

172 

4,194 

78 

1,425 

199 

3,193 

1,443 

1,734 

262 

911 

3,218 

699 

2,875 

1,618 

2,098 

777 

1,049 

1,489 

5,797 

935 

749 

667 

630 

454 

3,596 

2,152 

653 

290 

870 

990 

534 

974 

896 

1,225 

224 

591 

1,366 

269 

893 

841 

235 

236 

437 

2,014 

319 

29 

446 

367 

1,910 

804 

2,961 

1,439 

611 

658 

1,010 

7,066 

1,343 

1,777 

1,561 

420 

3,775 

578 

880 

180 

4,873 

113 

1,433 

216 

2,928 

1,687 

2,041 

254 

1,446 

4,228 

688 

2,716 

1,245 

2,084 

852 

1,388 

1,690 

5,573 

866 

841 

783 

595 

531 

3,910 

1,870 

668 

378 

968 

1,040 

581 

1,110 

1,066 

1,749 

270 

773 

1,453 

292 

803 

830 

370 

334 

398 

1,430 

317 

45 

U.S. CITY TOTAL 79,177 81,020 86,659 84,814 87,512 

San Juan, PR 241 150 142 106 165 

TOTAL 79,418 81,170 86,801 84,920 87,677 

Rates per 100,000 Population 

1996 1997 1998 1999 2000 

108.8 

116.5 

812.1 

190.8 

1,100.2 

507.1 

154.6 

331.5 

377.8 

402.7 

106.4 

222.2 

138.1 

113.4 

272.3 

181.6 

214.3 

83.3 

719.6 

24.7 

90.9 

53.4 

217.0 

419.2 

348.3 

185.2 

559.1 

73.2 

368.2 

712.2 

129.6 

388.1 

433.7 

494.4 

816.8 

179.6 

1,264.0 

696.9 

116.1 

461.1 

191.7 

442.6 

128.7 

79.8 

121.9 

1,059.8 

874.0 

120.3 

100.6 

63.6 

342.7 

27.4 

72.1 

996.2 

214.2 

134.4 

188.2 

90.6 

62.4 

332.8 

1,026.0 

133.7 

48.1 

121.3 147.4 166.4 173.0 

92.6 102.3 93.0 144.0 

844.0 884.0 892.2 537.2 

193.9 256.1 219.1 222.4 

1,116.4 1,233.5 1,154.8 1,002.8 

496.6 524.5 409.9 468.8 

183.6 188.4 182.6 227.7 

294.9 281.1 337.4 437.0 

357.8 356.0 370.0 323.9 

597.8 484.6 520.0 493.6 

253.1 378.4 300.1 337.9 

176.5 207.5 246.6 275.8 

203.0 302.6 308.1 315.7 

120.7 174.3 195.7 274.0 

333.7 378.3 378.1 372.2 

210.0 225.1 199.4 213.8 

232.1 209.9 263.9 361.7 

100.0 105.7 98.6 103.1 

761.5 722.1 706.8 821.3 

23.2 38.3 23.3 33.7 

113.7 229.7 208.5 209.7 

53.1 50.2 46.2 50.1 

224.1 247.8 198.1 181.6 

389.6 397.7 374.3 437.6 

304.3 439.7 486.8 573.0 

160.0 244.7 248.5 240.9 

374.3 537.4 423.6 672.4 

74.1 74.7 74.4 97.7 

337.0 261.7 220.0 216.6 

654.0 720.8 693.0 654.7 

120.1 147.9 156.2 120.2 

368.9 460.8 489.6 486.4 

371.9 427.6 437.5 479.7 

474.4 418.2 417.2 552.0 

697.2 711.5 697.4 791.6 

187.4 152.1 165.8 159.3 

829.2 732.8 696.4 645.0 

701.5 777.2 642.5 721.4 

106.6 118.8 104.5 122.7 

225.3 374.1 319.8 302.1 

166.4 175.7 210.8 246.6 

444.6 500.6 547.6 595.4 

134.8 154.8 152.2 132.2 

80.4 94.7 110.9 113.5 

114.2 115.3 118.6 154.6 

933.3 886.4 1,018.3 1,133.0 

780.3 828.5 856.4 899.6 

110.3 120.0 91.9 100.0 

123.1 129.8 147.1 167.6 

58.6 63.5 63.1 75.0 

335.5 394.3 331.2 472.8 

32.5 27.4 27.0 32.5 

63.7 79.8 72.0 94.2 

894.8 1,264.8 892.4 949.2 

135.8 186.4 207.8 225.6 

135.4 176.2 216.0 194.3 

232.4 177.7 183.8 181.4 

85.1 142.3 110.2 173.5 

75.7 59.0 60.1 85.0 

170.9 316.4 236.0 214.9 

1,062.5 1,062.7 828.7 588.4 

136.1 101.8 144.3 143.4 

47.8 54.4 31.2 48.5 

235.4 239.5 253.9 246.8 254.7 

61.4 38.2 28.3 21.0 32.7 

233.4 237.1 250.7 243.6 251.5 

STD Surveillance 2000 Gonorrhea Tables 99 
Table 20A. Gonorrhea — Reported cases by age, gender, and race/ethnicity: United States, 1996–2000 

Age 

Group 

Total 

Total Male Female 

White, Non-Hispanic 

Total Male Female 

Black, Non-Hispanic 

Total Male Female Total 

Hispanic 

Male Female 

Asian/Pacific Islander 

Total Male Female 

American Indian/ 

Alaska Native 

Total Male Female 

10-14 5,727 807 4,920 866 58 808 4,459 701 3,757 340 39 301 20 4 16 43 5 37 

15-19 92,271 32,683 59,588 14,194 2,480 11,715 72,368 28,322 44,046 4,787 1,697 3,090 351 58 293 571 126 445 

20-24 85,772 43,586 42,186 11,458 3,448 8,009 68,666 37,468 31,198 4,708 2,332 2,375 391 161 230 550 175 374 

199625-29 

30-34 

35-39 

44,638 25,611 19,027 

28,251 17,774 10,477 

18,457 12,698 5,759 

6,537 2,851 3,686 

4,719 2,522 2,198 

3,024 1,791 1,233 

34,896 21,053 13,843 

21,667 14,133 7,534 

14,314 10,242 4,072 

2,645 

1,497 

880 

1,461 

944 

533 

1,184 

553 

347 

240 117 123 

151 85 66 

91 54 37 

320 129 191 

216 91 125 

147 78 69 

40-44 10,284 7,954 2,330 1,604 1,088 516 8,108 6,499 1,609 446 291 155 48 29 19 77 47 30 

45-54 7,061 5,994 1,067 1,341 1,039 302 5,342 4,692 651 300 220 80 33 20 13 44 23 22 

55-64 1,714 1,549 165 311 262 49 1,316 1,219 97 73 61 12 10 4 6 4 3 1 

65+ 921 696 225 177 124 53 680 538 141 57 29 27 6 4 2 2 0 2 

TOTAL 296,411 149,826 146,585 44,482 15,739 28,743 232,736 125,228 107,508 15,857 7,637 8,220 1,351 539 812 1,984 682 1,301 

10-14 5,282 745 4,537 838 57 781 4,048 633 3,415 329 48 281 21 3 18 46 4 42 

15-19 90,131 30,979 59,151 13,564 2,287 11,277 70,582 26,811 43,771 4,987 1,667 3,321 394 87 307 604 128 476 

20-24 86,914 43,692 43,222 11,816 3,553 8,263 69,269 37,356 31,913 4,887 2,421 2,466 446 204 242 496 158 338 

199725-29 

30-34 

35-39 

45,665 26,505 19,160 

27,546 17,433 10,113 

18,645 12,796 5,849 

6,798 2,872 3,926 

4,704 2,509 2,195 

3,411 1,997 1,414 

35,505 21,751 13,754 

20,794 13,668 7,127 

14,034 10,038 3,997 

2,816 

1,671 

1,010 

1,649 

1,055 

668 

1,167 

616 

342 

264 122 142 

186 117 69 

83 48 35 

281 110 171 

192 85 107 

106 45 61 

40-44 10,550 8,225 2,325 1,744 1,209 536 8,195 6,610 1,585 486 339 147 62 38 24 63 30 34 

45-54 7,414 6,312 1,102 1,363 1,075 288 5,660 4,970 690 308 217 91 47 32 14 36 18 19 

55-64 1,819 1,616 203 347 269 78 1,368 1,264 104 82 69 14 11 8 3 10 7 3 

65+ 1,231 859 373 213 135 78 942 671 270 72 50 22 4 2 2 2 2 0 

TOTAL 296,242 149,551 146,691 44,952 16,000 28,952 231,189 124,085 107,104 16,739 8,218 8,521 1,521 663 858 1,841 585 1,256 

10-14 6,012 801 5,211 834 53 781 4,776 688 4,088 329 52 276 23 3 20 51 4 46 

15-19 103,454 33,742 69,712 15,542 2,520 13,023 81,063 29,050 52,013 5,656 1,958 3,699 457 80 377 735 134 600 

20-24 103,634 50,267 53,367 13,883 4,103 9,780 82,292 42,658 39,635 6,251 3,121 3,130 572 196 376 636 190 446 

199825-29 

30-34 

35-39 

54,549 31,378 23,171 

31,555 19,788 11,767 

22,404 15,241 7,163 

7,659 3,296 4,363 

5,295 2,865 2,430 

3,915 2,395 1,520 

42,647 25,782 16,865 

23,826 15,431 8,395 

16,938 11,864 5,074 

3,516 

2,042 

1,259 

2,029 

1,314 

837 

1,487 

728 

422 

355 159 197 

195 95 100 

140 82 58 

371 113 258 

196 83 113 

152 63 89 

40-44 12,803 9,650 3,153 2,104 1,393 711 9,914 7,730 2,184 627 432 195 75 48 27 82 47 35 

45-54 9,078 7,588 1,490 1,534 1,176 358 7,004 6,036 967 437 312 125 45 23 23 58 41 17 

55-64 2,127 1,891 236 396 344 53 1,598 1,450 148 107 82 25 11 6 4 16 10 6 

65+ 1,185 853 333 231 158 73 853 633 220 77 57 20 9 3 6 15 2 14 

TOTAL 347,903 171,578 176,325 51,557 18,347 33,210 271,754 141,623 130,130 20,380 10,215 10,165 1,891 698 1,193 2,321 694 1,627 

10-14 5,952 824 5,128 842 55 787 4,666 705 3,961 368 60 308 35 1 34 41 3 39 

15-19 104,429 34,294 70,135 14,882 2,437 12,445 81,912 29,452 52,460 6,359 2,151 4,208 562 133 429 713 121 592 

20-24 108,763 52,755 56,008 14,408 4,288 10,120 86,314 44,707 41,607 6,704 3,278 3,426 673 291 382 665 190 475 

199925-29 

30-34 

35-39 

56,118 32,608 23,510 

32,329 20,680 11,649 

23,435 16,212 7,224 

7,859 3,397 4,462 

5,364 2,864 2,499 

4,319 2,563 1,756 

43,873 26,820 17,053 

24,389 16,279 8,110 

17,559 12,684 4,875 

3,773 

2,131 

1,272 

2,114 

1,306 

815 

1,659 

825 

457 

316 173 142 

240 138 102 

146 91 55 

298 103 195 

206 93 113 

139 57 82 

40-44 14,005 10,652 3,353 2,395 1,671 725 10,832 8,492 2,340 638 410 228 69 38 32 70 41 29 

45-54 10,336 8,656 1,680 1,817 1,387 430 7,954 6,877 1,076 432 310 122 63 43 20 69 39 31 

55-64 2,354 2,121 233 503 432 71 1,718 1,587 131 109 83 26 14 11 3 11 8 3 

65+ 903 721 183 193 151 42 634 517 116 62 48 15 6 1 4 9 3 6 

TOTAL 359,707 179,915 179,792 52,732 19,295 33,437 280,700 148,433 132,267 21,920 10,602 11,318 2,130 925 1,205 2,226 660 1,565 

10-14 5,915 829 5,086 768 50 718 4,643 688 3,955 418 82 336 38 1 37 48 7 41 

15-19 101,958 33,281 68,677 14,596 2,574 12,022 79,178 28,084 51,094 6,871 2,313 4,559 669 180 489 644 131 513 

20-24 112,232 54,159 58,073 15,583 4,827 10,757 87,360 44,936 42,424 7,750 3,759 3,992 883 430 453 655 207 448 

200025-29 

30-34 

35-39 

55,881 32,807 23,074 

31,767 20,574 11,193 

22,575 15,744 6,830 

7,891 3,370 4,521 

5,794 3,185 2,609 

4,684 2,966 1,718 

42,893 26,548 16,345 

23,033 15,521 7,512 

16,020 11,578 4,443 

4,171 

2,344 

1,443 

2,415 

1,480 

932 

1,756 

864 

511 

565 351 214 

377 273 104 

250 181 70 

361 123 238 

218 114 105 

178 89 89 

40-44 13,512 10,224 3,287 2,722 1,839 883 9,900 7,788 2,112 668 449 219 126 96 30 96 52 44 

45-54 10,330 8,658 1,672 2,036 1,571 465 7,567 6,559 1,008 559 414 146 102 73 29 66 41 24 

55-64 2,297 2,076 221 495 436 59 1,635 1,513 123 115 91 24 30 19 11 22 17 5 

65+ 895 721 174 189 143 46 640 526 114 51 45 6 2 0 2 13 6 7 

TOTAL 358,440 179,484 178,956 54,912 21,017 33,894 273,670 144,049 129,621 24,489 12,018 12,470 3,053 1,607 1,445 2,317 792 1,525 

NOTE: These tables should be used only for race/ethnicity and age comparisons, not for overall totals or gender totals. This is because, if age or race/ethnicity was not specified, cases were prorated according to the distribution of cases for which these variables were specified. For the following years, the states 

listed did not report race/ethnicity for most cases and were excluded: 1996 (NJ, and NY); 1997 (ID, NJ, and NY); 1998 (ID and NJ). Cases and population denominators have been excluded for these states/areas. Differences between total cases from this table and others in the report are due to different reporting 

forms and above listed exclusions. The 0 to 9 year age group is not shown because some of these may not be due to sexual transmission; however, they are 

included in the totals. 

100 Gonorrhea Tables STD Surveillance 2000 
Table 20B. Gonorrhea — Reported rates per 100,000 population by age, gender, and race/ethnicity: United States, 

1996–2000 

Age 

Group Total 

Total 

Male Female 

White, Non-Hispanic 

Total Male Female 

Black, Non-Hispanic 

Total Male Female Total 

Hispanic 

Male Female 

Asian/Pacific Islander 

Total Male Female 

American Indian/ 

Alaska Native 

Total Male Female 

10-14 33.2 9.1 58.6 7.4 1.0 14.1 180.8 56.1 309.4 15.6 3.5 28.3 3.3 1.3 5.4 22.0 5.4 39.0 

15-19 543.7 373.6 724.7 123.0 41.7 209.2 2,924.9 2,256.9 3,612.5 216.2 144.2 297.9 61.8 20.3 104.6 329.8 144.7 517.9 

20-24 537.6 532.7 542.7 106.6 62.9 152.1 3,121.6 3,454.2 2,798.0 211.1 190.6 236.1 62.3 51.1 73.6 365.3 230.7 502.8 

25-29 

30-34 

35-39 

260.6 

147.6 

90.9 

297.7 

185.9 

125.3 

223.2 

109.3 

56.7 

55.1 48.1 62.1 

34.5 36.9 32.1 

20.1 23.7 16.4 

1,609.2 2,040.8 1,217.7 

927.8 1,294.6 605.8 

599.7 917.5 320.5 

118.0 

65.4 

43.6 

118.6 

76.9 

50.0 

117.2 

52.1 

36.4 

34.1 34.8 33.4 

21.6 25.5 18.1 

13.3 16.5 10.5 

215.6 170.6 262.7 

1996

145.3 123.6 166.7 

99.2 107.7 91.1 

40-44 54.8 85.3 24.6 11.2 15.2 7.2 385.1 662.9 143.0 27.5 34.7 19.8 7.6 9.8 5.7 57.9 73.3 43.6 

45-54 24.3 42.0 7.2 5.8 9.1 2.6 187.4 361.7 41.9 14.3 21.0 7.6 3.6 4.7 2.6 22.7 24.1 21.4 

55-64 8.9 17.0 1.6 2.0 3.5 0.6 73.4 156.4 9.6 5.9 10.6 1.8 1.8 1.6 2.0 3.5 4.7 2.3 

65+ 3.0 5.6 1.3 0.7 1.2 0.3 28.7 58.1 9.8 4.1 5.0 3.5 1.1 1.8 0.6 1.5 0.0 2.6 

TOTAL 124.0 127.9 120.2 25.2 18.3 31.9 824.4 935.2 724.4 63.8 59.5 68.4 17.2 14.2 19.9 105.3 73.6 135.9 

10-14 30.7 8.5 54.1 7.2 1.0 13.8 162.6 50.1 278.6 14.7 4.2 25.8 3.3 0.9 5.9 23.6 4.2 43.5 

15-19 521.8 347.9 706.8 116.1 38.0 199.0 2,793.4 2,090.5 3,518.0 217.5 136.8 309.0 66.2 28.9 104.5 339.9 143.7 537.8 

20-24 548.8 537.6 560.6 111.6 65.7 159.6 3,147.2 3,439.3 2,862.5 213.6 193.5 237.8 72.4 66.2 78.7 333.0 210.5 457.3 

25-29 

30-34 

35-39 

268.9 

148.6 

92.0 

310.8 

188.4 

126.4 

226.7 

108.9 

57.6 

58.3 49.3 67.3 

36.0 38.5 33.5 

22.9 26.7 19.0 

1,624.4 2,089.9 1,201.2 

907.1 1,275.9 583.6 

584.4 893.4 312.7 

124.5 

71.7 

48.0 

132.8 

84.1 

60.0 

114.5 

57.1 

34.5 

36.2 35.2 37.2 

26.1 34.6 18.4 

11.9 14.5 9.6 

187.7 143.5 234.1 

1997

132.4 117.4 147.4 

71.4 61.9 80.6 

40-44 54.9 86.2 24.1 12.0 16.7 7.4 373.8 645.7 135.6 28.3 38.1 17.7 9.3 12.3 6.7 46.5 45.4 47.6 

45-54 24.6 42.7 7.2 5.8 9.2 2.4 188.7 364.1 42.2 13.7 19.4 8.1 4.8 7.2 2.7 18.2 18.5 17.9 

55-64 9.3 17.4 2.0 2.2 3.5 1.0 74.5 158.3 10.0 6.4 11.3 2.0 2.0 3.1 1.1 8.4 11.7 5.4 

65+ 4.1 6.9 2.1 0.8 1.3 0.5 39.3 71.6 18.6 5.0 8.1 2.7 0.6 0.6 0.6 1.2 2.8 0.0 

TOTAL 123.3 127.0 119.8 25.6 18.6 32.2 808.8 915.0 712.9 65.1 61.8 68.5 18.7 17.0 20.4 97.2 62.8 130.5 

10-14 32.3 8.4 57.4 6.7 0.8 12.9 173.5 49.3 301.6 12.9 4.0 22.2 3.3 0.8 5.9 25.2 4.2 46.9 

15-19 547.1 347.1 758.8 123.2 38.8 212.8 2,907.2 2,051.9 3,789.5 216.4 143.8 295.2 64.7 22.5 108.0 389.5 141.9 638.4 

20-24 605.6 577.1 635.2 122.3 70.7 176.3 3,399.7 3,572.9 3,231.1 249.3 240.1 259.2 84.1 58.1 109.5 411.2 244.3 579.7 

25-29 

30-34 

35-39 

303.0 

162.0 

102.7 

350.3 

204.9 

140.5 

256.1 

119.8 

65.4 

62.9 54.2 71.6 

39.3 42.6 36.0 

24.8 30.3 19.3 

1,773.7 2,250.6 1,339.7 

959.6 1,331.8 634.0 

641.8 962.3 360.8 

143.5 

80.5 

52.7 

159.6 

99.8 

68.1 

126.1 

59.7 

36.4 

43.6 42.0 44.9 

23.5 24.6 22.5 

16.8 20.7 13.3 

236.8 140.8 337.3 

1998

133.0 112.8 153.2 

98.8 82.8 114.5 

40-44 60.6 92.2 29.6 13.4 17.7 9.0 401.9 672.7 165.7 31.7 43.2 20.0 9.6 12.9 6.6 57.6 67.7 48.0 

45-54 27.2 46.6 8.7 5.9 9.2 2.7 202.6 386.1 51.1 16.6 24.3 9.3 3.9 4.2 3.6 27.1 39.6 15.5 

55-64 9.7 18.2 2.1 2.3 4.1 0.6 76.0 159.4 12.4 7.0 11.5 3.0 1.6 2.1 1.2 12.7 16.4 9.3 

65+ 3.6 6.2 1.7 0.8 1.4 0.4 31.9 60.5 13.5 4.5 8.0 2.0 1.3 1.0 1.4 10.9 2.6 17.0 

TOTAL 133.3 134.6 132.1 27.3 19.9 34.4 859.0 945.8 780.9 69.9 69.5 70.3 20.0 15.4 24.3 117.7 71.5 162.3 

10-14 30.4 8.2 53.8 6.5 0.8 12.5 159.5 47.4 275.1 13.4 4.3 23.0 4.6 0.4 9.0 20.0 2.6 38.0 

15-19 528.8 337.8 730.8 113.5 36.1 195.5 2,833.7 2,004.8 3,690.4 228.7 148.9 315.2 73.5 34.5 113.4 365.4 123.9 607.7 

20-24 603.4 574.5 633.4 121.0 70.4 174.1 3,377.2 3,540.7 3,217.6 249.2 235.0 264.5 93.8 82.2 105.2 414.2 236.2 593.4 

25-29 

30-34 

35-39 

308.2 

163.9 

104.0 

360.1 

211.6 

144.5 

256.8 

117.0 

63.8 

64.6 55.9 73.4 

39.7 42.5 36.9 

26.7 31.7 21.8 

1,772.7 2,269.6 1,318.7 

967.1 1,380.6 603.9 

639.0 986.0 333.6 

146.8 

80.1 

49.2 

160.3 

95.0 

61.4 

132.6 

64.2 

36.4 

37.3 44.3 31.3 

27.0 33.5 21.4 

16.2 21.3 11.7 

186.5 127.1 248.0 

1999

139.1 124.8 153.6 

89.3 74.2 104.2 

40-44 62.9 96.5 29.9 14.5 20.3 8.8 413.7 695.3 167.5 29.5 37.5 21.3 8.1 9.3 7.1 47.6 57.4 38.3 

45-54 28.9 49.5 9.2 6.6 10.2 3.1 211.7 404.6 52.3 14.8 21.8 8.2 4.9 7.1 2.9 31.0 36.2 26.3 

55-64 10.1 19.0 1.9 2.7 4.8 0.7 76.4 163.4 10.2 6.5 10.7 2.8 1.9 3.1 0.8 8.2 12.7 4.3 

65+ 2.6 5.0 0.9 0.7 1.3 0.2 22.7 47.3 6.9 3.4 6.2 1.4 0.7 0.4 0.9 6.2 4.6 7.3 

TOTAL 131.9 135.0 129.0 26.9 20.1 33.4 848.2 947.0 759.4 69.9 67.3 72.7 20.9 18.9 22.7 109.9 66.3 152.0 

10-14 30.3 8.3 53.3 5.9 0.8 11.4 158.7 46.3 274.7 15.3 5.9 25.1 5.0 0.4 9.9 23.1 6.6 40.1 

15-19 516.3 327.9 715.6 111.3 38.1 188.9 2,739.1 1,911.6 3,594.3 247.1 160.0 341.4 87.5 46.6 129.3 329.7 133.5 526.6 

20-24 622.6 589.8 656.7 130.9 79.2 185.1 3,418.2 3,558.9 3,280.8 288.1 269.5 308.2 123.2 121.5 125.0 407.9 257.2 559.5 

25-29 

30-34 

35-39 

306.9 

161.0 

100.1 

362.3 

210.6 

140.4 

252.1 

112.4 

60.3 

64.9 55.4 74.4 

42.9 47.3 38.5 

29.0 36.6 21.3 

1,733.1 2,246.6 1,264.0 

913.3 1,316.4 559.4 

583.0 900.0 304.0 

162.3 

88.1 

55.9 

183.1 

107.6 

70.1 

140.4 

67.2 

40.7 

66.8 89.7 47.1 

42.5 66.6 21.8 

27.8 42.1 14.8 

226.1 151.3 303.6 

2000

147.6 152.8 142.3 

114.3 115.0 113.6 

40-44 60.7 92.6 29.3 16.5 22.3 10.7 378.1 637.7 151.2 30.8 41.0 20.4 14.7 23.7 6.6 65.4 73.1 58.1 

45-54 28.9 49.5 9.1 7.4 11.5 3.3 201.4 385.9 49.0 19.2 29.1 9.8 7.8 12.1 4.2 29.3 38.4 21.0 

55-64 9.8 18.6 1.8 2.7 4.8 0.6 72.7 155.8 9.6 6.8 11.7 2.7 4.1 5.5 2.9 16.7 27.9 6.8 

65+ 2.6 5.0 0.9 0.7 1.2 0.3 23.0 48.1 6.7 2.8 5.8 0.5 0.2 0.0 0.4 9.0 9.4 8.6 

TOTAL 131.4 134.7 128.4 28.0 21.9 33.9 827.0 919.0 744.2 78.1 76.3 80.1 30.0 32.9 27.3 114.4 79.5 148.1 

NOTE: These tables should be used only for race/ethnicity and age comparisons, not for overall totals or gender totals. This is because, if age or race/ethnicity was not specified, cases were prorated according to the distribution of cases for which these variables were specified. For the following years, the states 

listed did not report race/ethnicity for most cases and were excluded: 1996 (NJ, and NY); 1997 (ID, NJ, and NY); 1998 (ID and NJ). Cases and population denominators have been excluded for these states/areas. Differences between total cases from this table and others in the report are due to different reporting 

forms and above listed exclusions. The 0 to 9 year age group is not shown because some of these may not be due to sexual transmission; however, they are 

included in the totals. 

STD Surveillance 2000 Gonorrhea Tables 101 
Table 21. All stages of syphilis — Reported cases and rates by state/area listed in alphabetical order: United 

States and outlying areas, 1996–2000 

Cases Rates per 100,000 Population 

State/Area 1996 1997 1998 1999 2000 1996 1997 1998 1999 2000 

Alabama 1,889 1,486 1,139 1,019 752 44.1 34.4 26.2 23.3 17.2 

Alaska 15 12 13 13 6 2.5 2.0 2.1 2.1 1.0 

Arizona 468 600 697 833 847 10.6 13.2 14.9 17.4 17.7 

Arkansas 843 572 506 364 367 33.6 22.7 19.9 14.3 14.4 

California 4,420 3,828 2,869 2,859 3,354 13.9 11.9 8.8 8.6 10.1 

Colorado 165 153 122 91 63 4.3 3.9 3.1 2.2 1.6 

Connecticut 334 325 177 126 151 10.2 9.9 5.4 3.8 4.6 

Delaware 124 113 114 72 45 17.1 15.4 15.3 9.6 6.0 

Florida 2,912 2,746 2,539 2,690 2,768 20.2 18.7 17.0 17.8 18.3 

Georgia 2,953 2,835 1,836 1,973 1,635 40.3 37.9 24.0 25.3 21.0 

Hawaii 30 47 18 11 22 2.5 4.0 1.5 0.9 1.9 

Idaho 24 24 15 13 11 2.0 2.0 1.2 1.0 0.9 

Illinois 2,071 1,955 2,028 1,968 1,646 17.5 16.4 16.8 16.2 13.6 

Indiana 675 522 509 802 747 11.6 8.9 8.6 13.5 12.6 

Iowa 86 72 48 37 55 3.0 2.5 1.7 1.3 1.9 

Kansas 136 169 116 95 67 5.3 6.5 4.4 3.6 2.5 

Kentucky 398 403 339 302 253 10.3 10.3 8.6 7.6 6.4 

Louisiana 2,409 1,808 1,651 1,423 973 55.5 41.5 37.8 32.5 22.3 

Maine 4 13 4 1 7 0.3 1.0 0.3 0.1 0.6 

Maryland 2,234 2,455 2,156 1,385 1,172 44.1 48.2 42.0 26.8 22.7 

Massachusetts 633 730 568 385 447 10.4 11.9 9.2 6.2 7.2 

Michigan 851 794 692 780 984 8.7 8.1 7.0 7.9 10.0 

Minnesota 116 124 75 71 77 2.5 2.6 1.6 1.5 1.6 

Mississippi 2,365 1,441 1,161 906 685 87.2 52.8 42.2 32.7 24.7 

Missouri 618 503 379 396 299 11.5 9.3 7.0 7.2 5.5 

Montana 4 5 0 3 0 0.5 0.6 0.0 0.3 0.0 

Nebraska 27 34 35 24 7 1.6 2.1 2.1 1.4 0.4 

Nevada 142 120 139 92 52 8.9 7.2 8.0 5.1 2.9 

New Hampshire 29 26 14 17 19 2.5 2.2 1.2 1.4 1.6 

New Jersey 1,448 1,166 836 803 801 18.1 14.5 10.3 9.9 9.8 

New Mexico 78 103 76 80 98 4.6 6.0 4.4 4.6 5.6 

New York 6,529 5,645 5,148 4,094 2,945 36.0 31.1 28.3 22.5 16.2 

North Carolina 2,670 2,202 2,133 1,713 1,494 36.5 29.7 28.3 22.4 19.5 

North Dakota 0 0 0 0 1 0.0 0.0 0.0 0.0 0.2 

Ohio 1,324 761 474 364 282 11.9 6.8 4.2 3.2 2.5 

Oklahoma 467 410 369 539 327 14.2 12.4 11.0 16.1 9.7 

Oregon 70 48 32 37 49 2.2 1.5 1.0 1.1 1.5 

Pennsylvania 1,440 1,182 910 932 685 12.0 9.8 7.6 7.8 5.7 

Rhode Island 72 84 55 55 38 7.3 8.5 5.6 5.6 3.8 

South Carolina 1,286 1,139 876 929 853 34.6 30.3 22.8 23.9 22.0 

South Dakota 2 8 3 3 1 0.3 1.1 0.4 0.4 0.1 

Tennessee 2,322 2,368 1,754 1,737 1,708 43.8 44.1 32.3 31.7 31.1 

Texas 5,897 5,382 3,967 3,699 3,297 30.9 27.7 20.1 18.5 16.4 

Utah 49 56 58 49 59 2.4 2.7 2.8 2.3 2.8 

Vermont 1 1 6 3 0 0.2 0.2 1.0 0.5 0.0 

Virginia 1,265 1,118 719 722 537 19.0 16.6 10.6 10.5 7.8 

Washington 134 137 143 205 171 2.4 2.4 2.5 3.6 3.0 

West Virginia 59 20 11 15 13 3.2 1.1 0.6 0.8 0.7 

Wisconsin 496 317 257 191 184 9.6 6.1 4.9 3.6 3.5 

Wyoming 8 4 2 0 5 1.7 0.8 0.4 0.0 1.0 

U.S. TOTAL1 53,218 46,710 38,367 35,379 31,575 20.1 17.5 14.2 13.0 11.6 

Guam 3 1 3 12 9 2.0 0.6 1.9 7.3 5.5 

Puerto Rico 1,469 1,577 1,461 1,463 1,339 39.5 41.2 37.8 37.6 34.4 

Virgin Islands 17 10 35 13 11 15.5 9.1 31.9 11.5 9.7 

OUTLYING AREAS 1,489 1,588 1,499 1,488 1,359 37.4 38.8 36.3 35.7 32.6 

TOTAL 54,707 48,298 39,866 36,867 32,934 20.3 17.8 14.5 13.3 11.9 

1

Includes cases reported by Washington, D.C. 

102 Syphilis Tables STD Surveillance 2000 
Table 22. All stages of syphilis — Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1996–2000 

Cases 

City 1996 1997 1998 1999 2000 

Akron, OH 8 

Albuquerque, NM 33 

Atlanta, GA 835 

Austin, TX 88 

Baltimore, MD 1,552 

Birmingham, AL 703 

Boston, MA 257 

Buffalo, NY 22 

Charlotte, NC 312 

Chicago, IL 1,254 

Cincinnati, OH 166 

Cleveland, OH 377 

Columbus, OH 89 

Corpus Christi, TX 29 

Dallas, TX 790 

Dayton, OH 367 

Denver, CO 67 

Des Moines, IA 34 

Detroit, MI 522 

El Paso, TX 118 

Fort Worth, TX 379 

Honolulu, HI 26 

Houston, TX 2,047 

Indianapolis, IN 186 

Jacksonville, FL 228 

Jersey City, NJ 96 

Kansas City, MO 38 

Los Angeles, CA 2,193 

Louisville, KY 227 

Memphis, TN 1,371 

Miami, FL 876 

Milwaukee, WI 397 

Minneapolis, MN 52 

Nashville, TN 293 

New Orleans, LA 520 

New York City, NY 5,801 

Newark, NJ 363 

Norfolk, VA 222 

Oakland, CA 139 

Oklahoma City, OK 227 

Omaha, NE 7 

Philadelphia, PA 1,293 

Phoenix, AZ 342 

Pittsburgh, PA 16 

Portland, OR 45 

Richmond, VA 171 

Rochester, NY 68 

Sacramento, CA 58 

San Antonio, TX 378 

San Diego, CA 227 

San Francisco, CA 151 

San Jose, CA 70 

Seattle, WA 61 

St Louis, MO 329 

St Paul, MN 17 

St Petersburg, FL 86 

Tampa, FL 314 

Toledo, OH 63 

Tucson, AZ 61 

Tulsa, OK 109 

Washington, DC 626 

Wichita, KS 58 

Yonkers, NY 33 

4 

56 

872 

98 

1,781 

474 

305 

23 

153 

1,314 

93 

250 

117 

22 

717 

126 

72 

26 

548 

112 

299 

42 

1,937 

125 

206 

85 

13 

1,630 

232 

1,435 

874 

275 

53 

412 

463 

4,961 

241 

158 

128 

110 

17 

1,093 

473 

21 

23 

137 

32 

55 

309 

259 

171 

93 

62 

261 

8 

79 

207 

25 

52 

36 

644 

85 

34 

7 

45 

591 

56 

1,472 

246 

240 

12 

211 

1,457 

32 

151 

115 

27 

736 

39 

35 

20 

477 

81 

175 

18 

1,401 

239 

154 

34 

14 

1,264 

213 

1,036 

773 

233 

34 

416 

348 

4,652 

191 

108 

129 

181 

26 

804 

572 

12 

17 

81 

39 

31 

237 

187 

129 

62 

69 

170 

10 

56 

177 

23 

36 

75 

579 

21 

22 

6 

50 

580 

62 

941 

278 

164 

6 

194 

1,324 

12 

88 

109 

20 

695 

16 

46 

7 

569 

79 

177 

8 

1,111 

553 

74 

42 

66 

1,189 

174 

927 

795 

166 

28 

505 

228 

3,736 

172 

84 

127 

300 

10 

825 

722 

7 

19 

64 

16 

20 

228 

251 

128 

56 

123 

165 

6 

38 

111 

21 

42 

109 

458 

34 

12 

2 

63 

384 

59 

728 

212 

160 

10 

151 

1,100 

14 

42 

90 

10 

587 

17 

23 

18 

756 

92 

191 

15 

849 

518 

125 

27 

46 

1,857 

149 

881 

829 

151 

34 

523 

124 

2,711 

264 

84 

91 

193 

6 

618 

736 

7 

30 

40 

7 

25 

287 

232 

163 

43 

116 

115 

9 

64 

131 

18 

36 

32 

516 

10 

10 

U.S. CITY TOTAL 27,887 25,018 21,098 19,173 17,431 

San Juan, PR 722 719 673 682 545 

TOTAL 28,609 25,737 21,771 19,855 17,976 

Rates per 100,000 Population 

1996 1997 1998 1999 2000 

1.5 

6.3 

116.9 

12.9 

231.0 

106.4 

46.1 

6.8 

52.3 

43.0 

19.4 

27.0 

8.8 

9.2 

39.6 

64.9 

13.5 

9.6 

47.7 

17.2 

29.2 

3.0 

65.7 

22.8 

31.4 

44.2 

8.5 

25.8 

33.8 

158.5 

43.0 

43.2 

13.6 

55.0 

109.7 

79.1 

127.1 

95.4 

11.2 

51.7 

1.6 

87.8 

13.1 

1.2 

9.2 

89.5 

28.1 

5.2 

28.8 

8.5 

20.7 

4.4 

3.8 

94.2 

6.2 

9.9 

35.1 

13.9 

7.9 

28.6 

116.1 

13.4 

17.2 

0.8 1.3 1.1 0.4 

10.6 8.6 9.6 12.0 

120.7 79.9 77.9 51.6 

14.1 7.9 8.5 8.1 

271.0 228.0 148.7 115.1 

72.0 37.3 42.3 32.2 

54.7 43.1 29.5 28.8 

7.2 3.8 1.9 3.2 

24.9 33.4 29.9 23.3 

45.1 48.9 44.4 36.9 

10.9 3.8 1.4 1.7 

18.0 10.9 6.4 3.1 

11.5 11.3 10.6 8.8 

6.9 8.5 6.3 3.2 

35.4 35.9 33.7 28.5 

22.4 7.0 2.8 3.0 

14.4 7.0 9.2 4.6 

7.3 5.6 1.9 4.9 

50.3 37.8 45.4 60.3 

16.0 11.5 11.3 13.1 

22.5 12.9 12.8 13.8 

4.8 2.1 0.9 1.7 

61.3 43.7 34.2 26.1 

15.4 29.4 68.2 63.9 

28.1 20.9 10.0 16.9 

39.0 15.4 19.2 12.4 

2.9 3.1 14.6 10.2 

19.0 14.7 13.6 21.3 

34.6 31.7 25.9 22.1 

165.7 119.2 106.2 100.9 

42.7 35.9 36.5 38.1 

30.3 25.6 18.3 16.7 

13.8 9.3 7.6 9.3 

77.2 77.9 95.3 98.7 

98.7 74.8 49.5 26.9 

67.6 62.7 50.3 36.5 

84.7 67.2 60.7 93.2 

68.9 50.2 37.2 37.2 

10.2 10.1 9.8 7.0 

25.0 44.4 73.2 47.1 

3.9 5.9 2.2 1.3 

75.3 56.0 58.2 43.6 

17.5 20.5 25.2 25.7 

1.6 0.9 0.6 0.6 

4.7 3.4 3.8 6.0 

71.2 41.7 33.7 21.1 

13.3 16.2 6.7 2.9 

4.9 2.7 1.7 2.1 

23.2 17.5 16.6 20.9 

9.5 6.7 8.9 8.2 

23.4 17.3 17.1 21.8 

5.8 3.8 3.4 2.6 

3.8 4.2 7.4 7.0 

76.3 50.1 49.4 34.4 

2.9 3.7 2.2 3.3 

9.1 6.4 4.3 7.3 

22.8 19.1 11.8 13.9 

5.5 5.1 4.7 4.0 

6.7 4.6 5.2 4.5 

9.3 19.7 28.4 8.3 

121.7 110.7 88.2 99.4 

19.4 4.7 7.5 2.2 

17.6 11.4 6.2 5.1 

40.3 35.9 29.9 27.0 24.6 

82.8 82.4 64.3 64.8 51.8 

40.8 36.5 30.4 27.6 25.0 

STD Surveillance 2000 Syphilis Tables 103 
Table 23. Primary and secondary syphilis — Reported cases and rates by state/area, ranked by rates: United 

States and outlying areas, 2000 

Rank State/Area Cases Rate per 100,000 Population 

1 Tennessee 532 9.7 

2 North Carolina 483 6.3 

3 Indiana 351 5.9 

4 South Carolina 229 5.9 

5 Maryland 300 5.8 

6 Georgia 402 5.2 

7 Mississippi 137 4.9 

8 Louisiana 209 4.8 

9 Puerto Rico 175 4.5 

10 Arkansas 104 4.1 

11 Arizona 189 4.0 

12 Oklahoma 116 3.5 

13 Illinois 412 3.4 

14 Michigan 330 3.3 

15 Alabama 123 2.8 

16 Florida 413 2.7 

17 Virgin Islands 3 2.7 

U.S. TOTAL1 5,979 2.2 

18 Kentucky 85 2.1 

19 Texas 396 2.0 

20 Virginia 126 1.8 

21 Delaware 9 1.2 

22 Massachusetts 68 1.1 

23 Washington 66 1.1 

24 California 325 1.0 

25 New Jersey 71 0.9 

26 Wisconsin 48 0.9 

27 New Mexico 16 0.9 

28 New York 132 0.7 

29 Pennsylvania 77 0.6 

30 Ohio 69 0.6 

31 Guam 1 0.6 

32 Missouri 29 0.5 

33 Connecticut 16 0.5 

34 Oregon 12 0.4 

35 Iowa 11 0.4 

36 Rhode Island 4 0.4 

37 Minnesota 16 0.3 

38 Colorado 11 0.3 

39 Nevada 5 0.3 

YEAR 2010 OBJECTIVE 0.2 

40 Kansas 6 0.2 

41 West Virginia 3 0.2 

42 Hawaii 2 0.2 

43 New Hampshire 2 0.2 

44 Wyoming 1 0.2 

45 Nebraska 2 0.1 

46 Utah 2 0.1 

47 Idaho 1 0.1 

48 Maine 1 0.1 

49 Alaska 0 0.0 

50 Montana 0 0.0 

51 North Dakota 0 0.0 

52 South Dakota 0 0.0 

53 Vermont 0 0.0 

1

Includes cases reported by Washington, D.C., but excludes outlying areas (Guam, Puerto Rico and Virgin Islands). 

104 Syphilis Tables STD Surveillance 2000 
Table 24. Primary and secondary syphilis — Counties and independent cities* ranked by number of reported 

cases: United States, 2000** 

Rank County/Independent City Cases Rate per 100,000 Population Cumulative Percent 

1 Cook County, IL 326 6.3 5 

2 Marion County, IN 301 37.1 10 

3 Wayne County, MI 288 13.7 15 

4 Shelby County, TN 246 28.2 19 

5 Baltimore (City), MD 218 34.5 23 

6 Fulton County, GA 203 27.3 26 

7 Davidson County, TN 200 37.7 29 

8 Maricopa County, AZ 172 6.0 32 

9 Los Angeles County, CA 152 1.6 35 

10 Dade County, FL 126 5.8 37 

11 Dallas County, TX 100 4.8 39 

12 Oklahoma County, OK 90 14.1 40 

13 Guilford County, NC 70 17.9 41 

14 Harris County, TX 70 2.2 42 

15 Bexar County, TX 67 4.9 43 

16 Philadelphia County, PA 67 4.7 45 

17 New York County, NY 62 4.0 46 

18 Robeson County, NC 58 49.7 47 

19 Jefferson County, KY 57 8.5 48 

20 Palm Beach County, FL 54 5.1 48 

21 San Francisco County, CA 51 6.8 49 

22 King County, WA 50 3.0 50 

*Accounting for 50% of reported primary and secondary syphilis cases.
 

**Corrections to the reported number of cases in the future could alter the ranking and/or inclusion of the counties and independent cities in this table.
 

STD Surveillance 2000 Syphilis Tables 105 
Table 25. Primary and secondary syphilis — Reported cases and rates by state/area and region listed in 

alphabetical order: United States and outlying areas, 1996–2000 

Cases Rates per 100,000 Population 

State/Area 1996 1997 1998 1999 2000 1996 1997 1998 1999 2000 

Alabama 528 410 274 202 123 12.3 9.5 6.3 4.6 2.8 

Alaska 0 1 1 1 0 0.0 0.2 0.2 0.2 0.0 

Arizona 102 132 185 212 189 2.3 2.9 4.0 4.4 4.0 

Arkansas 262 173 108 87 104 10.5 6.9 4.3 3.4 4.1 

California 509 386 327 283 325 1.6 1.2 1.0 0.9 1.0 

Colorado 26 15 10 8 11 0.7 0.4 0.3 0.2 0.3 

Connecticut 103 62 26 16 16 3.2 1.9 0.8 0.5 0.5 

Delaware 35 22 21 10 9 4.8 3.0 2.8 1.3 1.2 

Florida 368 296 294 343 413 2.6 2.0 2.0 2.3 2.7 

Georgia 689 515 333 430 402 9.4 6.9 4.4 5.5 5.2 

Hawaii 3 1 4 3 2 0.3 0.1 0.3 0.3 0.2 

Idaho 4 1 2 1 1 0.3 0.1 0.2 0.1 0.1 

Illinois 501 435 424 422 412 4.2 3.7 3.5 3.5 3.4 

Indiana 207 151 215 450 351 3.6 2.6 3.6 7.6 5.9 

Iowa 23 7 5 9 11 0.8 0.2 0.2 0.3 0.4 

Kansas 28 32 14 14 6 1.1 1.2 0.5 0.5 0.2 

Kentucky 154 135 106 101 85 4.0 3.5 2.7 2.5 2.1 

Louisiana 533 364 430 306 209 12.3 8.4 9.8 7.0 4.8 

Maine 1 2 1 0 1 0.1 0.2 0.1 0.0 0.1 

Maryland 729 891 648 343 300 14.4 17.5 12.6 6.6 5.8 

Massachusetts 85 78 46 37 68 1.4 1.3 0.7 0.6 1.1 

Michigan 183 153 211 249 330 1.9 1.6 2.1 2.5 3.3 

Minnesota 16 16 9 10 16 0.3 0.3 0.2 0.2 0.3 

Mississippi 817 390 261 194 137 30.1 14.3 9.5 7.0 4.9 

Missouri 221 118 109 96 29 4.1 2.2 2.0 1.8 0.5 

Montana 0 0 0 1 0 0.0 0.0 0.0 0.1 0.0 

Nebraska 6 3 8 6 2 0.4 0.2 0.5 0.4 0.1 

Nevada 20 11 15 5 5 1.2 0.7 0.9 0.3 0.3 

New Hampshire 1 0 2 1 2 0.1 0.0 0.2 0.1 0.2 

New Jersey 177 150 107 68 71 2.2 1.9 1.3 0.8 0.9 

New Mexico 3 9 14 12 16 0.2 0.5 0.8 0.7 0.9 

New York 214 138 119 150 132 1.2 0.8 0.7 0.8 0.7 

North Carolina 1,052 721 723 464 483 14.4 9.7 9.6 6.1 6.3 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 584 218 134 92 69 5.2 1.9 1.2 0.8 0.6 

Oklahoma 179 117 98 187 116 5.4 3.5 2.9 5.6 3.5 

Oregon 9 10 6 8 12 0.3 0.3 0.2 0.2 0.4 

Pennsylvania 164 123 98 84 77 1.4 1.0 0.8 0.7 0.6 

Rhode Island 4 2 1 3 4 0.4 0.2 0.1 0.3 0.4 

South Carolina 402 378 271 269 229 10.8 10.1 7.1 6.9 5.9 

South Dakota 0 1 1 0 0 0.0 0.1 0.1 0.0 0.0 

Tennessee 850 747 567 641 532 16.0 13.9 10.4 11.7 9.7 

Texas 890 676 443 473 396 4.7 3.5 2.2 2.4 2.0 

Utah 3 5 4 2 2 0.1 0.2 0.2 0.1 0.1 

Vermont 0 0 4 3 0 0.0 0.0 0.7 0.5 0.0 

Virginia 393 237 149 153 126 5.9 3.5 2.2 2.2 1.8 

Washington 9 17 44 77 66 0.2 0.3 0.8 1.3 1.1 

West Virginia 7 1 3 5 3 0.4 0.1 0.2 0.3 0.2 

Wisconsin 176 89 78 41 48 3.4 1.7 1.5 0.8 0.9 

Wyoming 2 0 1 0 1 0.4 0.0 0.2 0.0 0.2 

U.S. TOTAL1 11,388 8,556 7,035 6,617 5,979 4.3 3.2 2.6 2.4 2.2 

Northeast 749 555 404 362 371 1.5 1.1 0.8 0.7 0.7 

Midwest 1,945 1,223 1,208 1,389 1,274 3.1 2.0 1.9 2.2 2.0 

South 8,004 6,190 4,810 4,253 3,704 8.6 6.6 5.0 4.4 3.8 

West 690 588 613 613 630 1.2 1.0 1.0 1.0 1.0 

Guam 0 0 0 2 1 0.0 0.0 0.0 1.2 0.6 

Puerto Rico 208 249 177 146 175 5.6 6.5 4.6 3.8 4.5 

Virgin Islands 11 2 7 1 3 10.0 1.8 6.4 0.9 2.7 

OUTLYING AREAS 219 251 184 149 179 5.5 6.1 4.5 3.6 4.3 

TOTAL 11,607 8,807 7,219 6,766 6,158 4.3 3.2 2.6 2.4 2.2 

1

Includes cases reported by Washington, D.C. 

106 Syphilis Tables STD Surveillance 2000 
Table 26. Primary and secondary syphilis — Women – Reported cases and rates by state/area listed in 

alphabetical order: United States and outlying areas, 1996–2000 

Cases Rates per 100,000 Population 

State/Area 1996 1997 1998 1999 2000 1996 1997 1998 1999 2000 

Alabama 244 183 133 102 63 11.0 8.2 5.9 4.5 2.8 

Alaska 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Arizona 43 37 67 65 80 1.9 1.6 2.8 2.7 3.3 

Arkansas 144 103 59 44 58 11.1 7.9 4.5 3.3 4.4 

California 187 116 132 76 51 1.2 0.7 0.8 0.5 0.3 

Colorado 10 5 3 6 1 0.5 0.3 0.1 0.3 0.0 

Connecticut 58 25 16 6 7 3.5 1.5 0.9 0.4 0.4 

Delaware 14 10 11 1 1 3.8 2.7 2.9 0.3 0.3 

Florida 172 131 116 143 163 2.3 1.7 1.5 1.8 2.1 

Georgia 284 194 130 160 159 7.6 5.1 3.3 4.0 4.0 

Hawaii 1 0 0 2 1 0.2 0.0 0.0 0.3 0.2 

Idaho 3 0 0 0 0 0.5 0.0 0.0 0.0 0.0 

Illinois 246 194 171 180 181 4.1 3.2 2.8 2.9 2.9 

Indiana 115 82 113 225 196 3.8 2.7 3.7 7.4 6.4 

Iowa 16 4 0 6 6 1.1 0.3 0.0 0.4 0.4 

Kansas 10 12 6 8 1 0.8 0.9 0.4 0.6 0.1 

Kentucky 81 66 49 45 42 4.1 3.3 2.4 2.2 2.1 

Louisiana 271 187 196 153 97 12.0 8.3 8.6 6.7 4.3 

Maine 0 1 0 0 0 0.0 0.2 0.0 0.0 0.0 

Maryland 329 400 302 164 115 12.7 15.3 11.4 6.2 4.3 

Massachusetts 30 33 15 15 19 1.0 1.0 0.5 0.5 0.6 

Michigan 82 68 86 95 141 1.6 1.4 1.7 1.9 2.8 

Minnesota 8 4 4 5 5 0.3 0.2 0.2 0.2 0.2 

Mississippi 427 201 128 93 70 30.3 14.2 8.9 6.4 4.9 

Missouri 103 63 50 49 11 3.7 2.3 1.8 1.7 0.4 

Montana 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Nebraska 4 0 3 3 1 0.5 0.0 0.4 0.4 0.1 

Nevada 10 6 3 3 2 1.3 0.7 0.3 0.3 0.2 

New Hampshire 0 0 1 1 0 0.0 0.0 0.2 0.2 0.0 

New Jersey 81 59 37 32 23 2.0 1.4 0.9 0.8 0.5 

New Mexico 1 5 8 3 5 0.1 0.6 0.9 0.3 0.6 

New York 92 56 28 34 12 1.0 0.6 0.3 0.4 0.1 

North Carolina 484 353 347 202 234 12.9 9.3 8.9 5.1 5.9 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 287 101 72 43 26 5.0 1.8 1.2 0.7 0.4 

Oklahoma 80 53 45 77 54 4.8 3.1 2.6 4.5 3.1 

Oregon 3 2 2 5 4 0.2 0.1 0.1 0.3 0.2 

Pennsylvania 62 52 31 27 30 1.0 0.8 0.5 0.4 0.5 

Rhode Island 1 1 1 1 2 0.2 0.2 0.2 0.2 0.4 

South Carolina 182 173 131 117 96 9.5 8.9 6.6 5.8 4.8 

South Dakota 0 0 1 0 0 0.0 0.0 0.3 0.0 0.0 

Tennessee 422 370 284 283 247 15.4 13.3 10.1 10.0 8.7 

Texas 437 315 183 182 152 4.5 3.2 1.8 1.8 1.5 

Utah 0 2 0 0 1 0.0 0.2 0.0 0.0 0.1 

Vermont 0 0 1 2 0 0.0 0.0 0.3 0.7 0.0 

Virginia 204 112 61 71 44 6.0 3.3 1.8 2.0 1.3 

Washington 2 8 7 3 8 0.1 0.3 0.2 0.1 0.3 

West Virginia 6 1 2 3 1 0.6 0.1 0.2 0.3 0.1 

Wisconsin 85 49 40 18 24 3.3 1.9 1.5 0.7 0.9 

Wyoming 1 0 0 0 1 0.4 0.0 0.0 0.0 0.4 

U.S. TOTAL1 5,379 3,895 3,109 2,777 2,445 4.0 2.9 2.2 2.0 1.8 

Guam 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Puerto Rico 100 116 81 73 76 5.2 5.8 4.0 3.6 3.8 

Virgin Islands 5 0 1 1 2 8.8 0.0 1.7 1.9 3.9 

OUTLYING AREAS 105 116 82 74 78 5.1 5.5 3.8 3.4 3.6 

TOTAL 5,484 4,011 3,191 2,851 2,523 4.0 2.9 2.3 2.0 1.8 

1

Includes cases reported by Washington, D.C.
 

NOTE: Cases and rates underestimated in some areas because of under-reporting or non-reporting by gender.
 

STD Surveillance 2000 Syphilis Tables 107 
Table 27. Primary and secondary syphilis — Men – Reported cases and rates by state/area listed in 

alphabetical order: United States and outlying areas, 1996–2000 

Cases Rates per 100,000 Population 

State/Area 1996 1997 1998 1999 2000 1996 1997 1998 1999 2000 

Alabama 284 227 141 100 60 13.8 10.9 6.8 4.8 2.9 

Alaska 0 1 1 1 0 0.0 0.3 0.3 0.3 0.0 

Arizona 59 95 118 147 109 2.7 4.2 5.1 6.2 4.6 

Arkansas 118 70 49 43 46 9.7 5.7 4.0 3.5 3.7 

California 322 270 195 206 272 2.0 1.7 1.2 1.2 1.6 

Colorado 16 10 7 2 10 0.8 0.5 0.4 0.1 0.5 

Connecticut 45 37 10 10 9 2.8 2.3 0.6 0.6 0.6 

Delaware 21 12 10 9 8 6.0 3.4 2.8 2.5 2.2 

Florida 196 165 178 199 250 2.8 2.3 2.5 2.7 3.4 

Georgia 405 321 203 269 243 11.3 8.8 5.5 7.1 6.4 

Hawaii 2 1 4 1 1 0.3 0.2 0.7 0.2 0.2 

Idaho 1 1 2 1 1 0.2 0.2 0.3 0.2 0.2 

Illinois 255 241 253 242 231 4.4 4.1 4.3 4.1 3.9 

Indiana 92 69 102 225 155 3.2 2.4 3.6 7.8 5.4 

Iowa 7 3 5 3 5 0.5 0.2 0.4 0.2 0.4 

Kansas 18 20 8 6 5 1.4 1.6 0.6 0.5 0.4 

Kentucky 73 69 57 56 43 3.9 3.6 3.0 2.9 2.2 

Louisiana 262 177 234 153 112 12.5 8.4 11.1 7.3 5.3 

Maine 1 1 1 0 1 0.2 0.2 0.2 0.0 0.2 

Maryland 400 490 346 179 185 16.2 19.8 13.9 7.1 7.4 

Massachusetts 55 45 31 22 49 1.9 1.5 1.0 0.7 1.6 

Michigan 101 85 125 154 189 2.1 1.8 2.6 3.2 3.9 

Minnesota 8 12 5 5 11 0.3 0.5 0.2 0.2 0.5 

Mississippi 390 189 131 101 67 30.0 14.4 9.9 7.6 5.1 

Missouri 118 55 59 47 18 4.5 2.1 2.2 1.8 0.7 

Montana 0 0 0 1 0 0.0 0.0 0.0 0.2 0.0 

Nebraska 2 3 5 3 1 0.2 0.4 0.6 0.4 0.1 

Nevada 10 5 12 2 3 1.2 0.6 1.3 0.2 0.3 

New Hampshire 1 0 1 0 2 0.2 0.0 0.2 0.0 0.3 

New Jersey 96 91 70 36 48 2.5 2.3 1.8 0.9 1.2 

New Mexico 2 4 6 9 11 0.2 0.5 0.7 1.1 1.3 

New York 122 82 91 116 120 1.4 0.9 1.0 1.3 1.4 

North Carolina 568 368 376 262 249 16.0 10.2 10.3 7.1 6.7 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 297 117 62 49 43 5.5 2.2 1.1 0.9 0.8 

Oklahoma 99 64 53 110 62 6.1 3.9 3.2 6.7 3.8 

Oregon 6 8 4 3 8 0.4 0.5 0.2 0.2 0.5 

Pennsylvania 102 71 67 57 47 1.8 1.2 1.2 1.0 0.8 

Rhode Island 3 1 0 2 2 0.6 0.2 0.0 0.4 0.4 

South Carolina 220 205 140 152 133 12.3 11.3 7.6 8.1 7.1 

South Dakota 0 1 0 0 0 0.0 0.3 0.0 0.0 0.0 

Tennessee 428 377 283 358 285 16.7 14.5 10.8 13.5 10.8 

Texas 453 361 260 289 244 4.8 3.8 2.7 2.9 2.5 

Utah 3 3 4 2 1 0.3 0.3 0.4 0.2 0.1 

Vermont 0 0 3 1 0 0.0 0.0 1.0 0.3 0.0 

Virginia 189 125 88 82 82 5.8 3.8 2.7 2.4 2.4 

Washington 7 9 37 74 58 0.3 0.3 1.3 2.6 2.0 

West Virginia 1 0 1 2 2 0.1 0.0 0.1 0.2 0.2 

Wisconsin 91 40 38 23 24 3.6 1.6 1.5 0.9 0.9 

Wyoming 1 0 1 0 0 0.4 0.0 0.4 0.0 0.0 

U.S. TOTAL1 6,009 4,660 3,924 3,835 3,532 4.6 3.6 3.0 2.9 2.7 

Guam 0 0 0 2 1 0.0 0.0 0.0 2.3 1.2 

Puerto Rico 108 133 96 73 99 6.0 7.2 5.2 3.9 5.3 

Virgin Islands 6 2 6 0 1 11.4 3.8 11.3 0.0 1.6 

OUTLYING AREAS 114 135 102 75 101 5.9 6.8 5.1 3.7 5.0 

TOTAL 6,123 4,795 4,026 3,910 3,633 4.7 3.6 3.0 2.9 2.7 

1

Includes cases reported by Washington, D.C.
 

NOTE: Cases and rates underestimated in some areas because of under-reporting or non-reporting by gender.
 

108 Syphilis Tables STD Surveillance 2000 
10

20

30

40

50

60

Table 28. Primary and secondary syphilis — Reported cases and rates in selected cities of >200,000 

population, ranked by rates: United States and outlying areas, 2000 

Rank City Cases Rate per 100,000 Population 

1 Nashville, TN 200 37.7 

2 Indianapolis, IN 301 37.1 

3 Baltimore, MD 218 34.5 

4 Memphis, TN 246 28.2 

5 Detroit, MI 274 21.9 

6 Oklahoma City, OK 82 20.0 

7 Norfolk, VA 37 16.4 

8 Atlanta, GA 116 15.6 

9 Newark, NJ 28 9.9 

Chicago, IL 292 9.8 

11 Louisville, KY 57 8.5 

12 San Francisco, CA 53 7.1 

13 Washington, DC 37 7.1 

14 Charlotte, NC 45 6.9 

15 San Juan, PR 68 6.5 

16 Phoenix, AZ 172 6.0 

17 Miami, FL 126 5.8 

18 San Antonio, TX 67 4.9 

19 Dallas, TX 100 4.8 

New Orleans, LA 22 4.8 

21 Philadelphia, PA 67 4.7 

22 Milwaukee, WI 43 4.7 

23 Boston, MA 25 4.5 

24 Columbus, OH 40 3.9 

25 Birmingham, AL 24 3.7 

26 St Louis, MO 11 3.3 

27 Jacksonville, FL 24 3.2 

28 Seattle, WA 50 3.0 

29 Richmond, VA 5 2.6 

Minneapolis, MN 9 2.5 

31 Houston, TX 70 2.2 

32 Portland, OR 11 2.2 

33 Tampa, FL 20 2.1 

34 Albuquerque, NM 11 2.1 

35 Tulsa, OK 8 2.1 

36 New York City, NY 117 1.6 

37 Fort Worth, TX 22 1.6 

38 Los Angeles, CA 133 1.5 

39 Austin, TX 8 1.1 

San Diego, CA 27 1.0 

41 Tucson, AZ 8 1.0 

42 Oakland, CA 11 0.9 

43 El Paso, TX 6 0.9 

44 Dayton, OH 5 0.9 

45 St Petersburg, FL 7 0.8 

46 Denver, CO 4 0.8 

47 St Paul, MN 2 0.7 

48 Jersey City, NJ 1 0.5 

49 Yonkers, NY 1 0.5 

Wichita, KS 2 0.4 

51 Omaha, NE 2 0.4 

52 Toledo, OH 2 0.4 

53 Rochester, NY 1 0.4 

54 Cleveland, OH 4 0.3 

55 Des Moines, IA 1 0.3 

56 Buffalo, NY 1 0.3 

57 Corpus Christi, TX 1 0.3 

YEAR 2010 OBJECTIVE 0.2 

58 Pittsburgh, PA 3 0.2 

59 Kansas City, MO 1 0.2 

San Jose, CA 2 0.1 

61 Sacramento, CA 1 0.1 

62 Honolulu, HI 1 0.1 

63 Akron, OH 0 0.0 

64 Cincinnati, OH 0 0.0 

STD Surveillance 2000 Syphilis Tables 109 
Table 29. Primary and secondary syphilis — Reported cases and rates in selected cities of >200,000 

population listed in alphabetical order: United States and outlying areas, 1996–2000 

Cases 

City 1996 1997 1998 1999 2000 

Akron, OH 0 

Albuquerque, NM 2 

Atlanta, GA 247 

Austin, TX 9 

Baltimore, MD 553 

Birmingham, AL 202 

Boston, MA 42 

Buffalo, NY 6 

Charlotte, NC 135 

Chicago, IL 343 

Cincinnati, OH 76 

Cleveland, OH 130 

Columbus, OH 54 

Corpus Christi, TX 0 

Dallas, TX 236 

Dayton, OH 201 

Denver, CO 11 

Des Moines, IA 6 

Detroit, MI 92 

El Paso, TX 10 

Fort Worth, TX 95 

Honolulu, HI 3 

Houston, TX 151 

Indianapolis, IN 85 

Jacksonville, FL 75 

Jersey City, NJ 10 

Kansas City, MO 7 

Los Angeles, CA 213 

Louisville, KY 104 

Memphis, TN 397 

Miami, FL 38 

Milwaukee, WI 158 

Minneapolis, MN 4 

Nashville, TN 193 

New Orleans, LA 169 

New York City, NY 138 

Newark, NJ 25 

Norfolk, VA 92 

Oakland, CA 10 

Oklahoma City, OK 114 

Omaha, NE 2 

Philadelphia, PA 141 

Phoenix, AZ 89 

Pittsburgh, PA 2 

Portland, OR 7 

Richmond, VA 66 

Rochester, NY 13 

Sacramento, CA 6 

San Antonio, TX 25 

San Diego, CA 36 

San Francisco, CA 33 

San Jose, CA 3 

Seattle, WA 1 

St Louis, MO 142 

St Paul, MN 3 

St Petersburg, FL 8 

Tampa, FL 44 

Toledo, OH 30 

Tucson, AZ 10 

Tulsa, OK 40 

Washington, DC 116 

Wichita, KS 15 

Yonkers, NY 0 

4 

9 

204 

8 

669 

107 

52 

2 

48 

346 

34 

61 

54 

2 

148 

28 

8 

0 

94 

3 

39 

1 

180 

71 

36 

9 

2 

108 

107 

343 

49 

84 

12 

203 

132 

97 

26 

44 

7 

39 

1 

108 

118 

5 

3 

49 

2 

4 

27 

23 

52 

5 

11 

64 

0 

11 

34 

6 

12 

8 

117 

16 

2 

3 

11 

163 

15 

466 

36 

23 

4 

69 

338 

12 

30 

55 

0 

126 

6 

3 

3 

152 

2 

26 

4 

99 

165 

16 

1 

6 

120 

91 

260 

31 

71 

4 

210 

105 

81 

27 

33 

11 

61 

4 

89 

173 

0 

4 

22 

7 

1 

26 

24 

25 

3 

33 

58 

3 

8 

32 

8 

7 

14 

81 

3 

1 

0 

11 

213 

19 

246 

24 

16 

1 

53 

282 

1 

12 

43 

1 

151 

2 

4 

0 

189 

9 

22 

3 

77 

407 

7 

3 

8 

83 

67 

258 

82 

39 

6 

250 

51 

130 

22 

20 

10 

114 

5 

69 

195 

2 

5 

13 

0 

2 

31 

25 

29 

3 

65 

51 

2 

4 

15 

6 

8 

45 

45 

7 

1 

0 

11 

116 

8 

218 

24 

25 

1 

45 

292 

0 

4 

40 

1 

100 

5 

4 

1 

274 

6 

22 

1 

70 

301 

24 

1 

1 

133 

57 

246 

126 

43 

9 

200 

22 

117 

28 

37 

11 

82 

2 

67 

172 

3 

11 

5 

1 

1 

67 

27 

53 

2 

50 

11 

2 

7 

20 

2 

8 

8 

37 

2 

1 

U.S. CITY TOTAL 5,268 4,148 3,565 3,564 3,265 

San Juan, PR 74 99 79 61 68 

TOTAL 5,342 4,247 3,644 3,625 3,333 

Rates per 100,000 Population 

1996 1997 1998 1999 2000 

0.0 

0.4 

34.6 

1.3 

82.3 

30.6 

7.5 

1.9 

22.6 

11.7 

8.9 

9.3 

5.3 

0.0 

11.8 

35.5 

2.2 

1.7 

8.4 

1.5 

7.3 

0.3 

4.8 

10.4 

10.3 

4.6 

1.6 

2.5 

15.5 

45.9 

1.9 

17.2 

1.0 

36.2 

35.6 

1.9 

8.8 

39.5 

0.8 

26.0 

0.5 

9.6 

3.4 

0.2 

1.4 

34.6 

5.4 

0.5 

1.9 

1.3 

4.5 

0.2 

0.1 

40.7 

1.1 

0.9 

4.9 

6.6 

1.3 

10.5 

21.5 

3.5 

0.0 

0.8 0.6 0.0 0.0 

1.7 2.1 2.1 2.1 

28.2 22.0 28.6 15.6 

1.2 2.1 2.6 1.1 

101.8 72.2 38.9 34.5 

16.2 5.5 3.7 3.7 

9.3 4.1 2.9 4.5 

0.6 1.3 0.3 0.3 

7.8 10.9 8.2 6.9 

11.9 11.3 9.5 9.8 

4.0 1.4 0.1 0.0 

4.4 2.2 0.9 0.3 

5.3 5.4 4.2 3.9 

0.6 0.0 0.3 0.3 

7.3 6.1 7.3 4.8 

5.0 1.1 0.4 0.9 

1.6 0.6 0.8 0.8 

0.0 0.8 0.0 0.3 

8.6 12.1 15.1 21.9 

0.4 0.3 1.3 0.9 

2.9 1.9 1.6 1.6 

0.1 0.5 0.3 0.1 

5.7 3.1 2.4 2.2 

8.7 20.3 50.2 37.1 

4.9 2.2 0.9 3.2 

4.1 0.5 1.4 0.5 

0.4 1.3 1.8 0.2 

1.3 1.4 1.0 1.5 

16.0 13.5 10.0 8.5 

39.6 29.9 29.6 28.2 

2.4 1.4 3.8 5.8 

9.2 7.8 4.3 4.7 

3.1 1.1 1.6 2.5 

38.0 39.3 47.2 37.7 

28.1 22.6 11.1 4.8 

1.3 1.1 1.8 1.6 

9.1 9.5 7.8 9.9 

19.2 15.3 8.9 16.4 

0.6 0.9 0.8 0.9 

8.9 15.0 27.8 20.0 

0.2 0.9 1.1 0.4 

7.4 6.2 4.9 4.7 

4.4 6.2 6.8 6.0 

0.4 0.0 0.2 0.2 

0.6 0.8 1.0 2.2 

25.5 11.3 6.9 2.6 

0.8 2.9 0.0 0.4 

0.4 0.1 0.2 0.1 

2.0 1.9 2.3 4.9 

0.8 0.9 0.9 1.0 

7.1 3.4 3.9 7.1 

0.3 0.2 0.2 0.1 

0.7 2.0 3.9 3.0 

18.7 17.1 15.3 3.3 

0.0 1.1 0.7 0.7 

1.3 0.9 0.5 0.8 

3.7 3.5 1.6 2.1 

1.3 1.8 1.3 0.4 

1.5 0.9 1.0 1.0 

2.1 3.7 11.7 2.1 

22.1 15.5 8.7 7.1 

3.6 0.7 1.5 0.4 

1.0 0.5 0.5 0.5 

7.6 6.0 5.1 5.0 4.6 

8.5 11.4 7.5 5.8 6.5 

7.6 6.0 5.1 5.0 4.6 

110 Syphilis Tables STD Surveillance 2000 
Table 30. Primary and secondary syphilis — Women – Reported cases and rates in selected cities of >200,000 

population listed in alphabetical order: United States and outlying areas, 1996–2000 

Cases 

City 1996 1997 1998 1999 2000 

Akron, OH 0 

Albuquerque, NM 1 

Atlanta, GA 86 

Austin, TX 6 

Baltimore, MD 240 

Birmingham, AL 81 

Boston, MA 14 

Buffalo, NY 1 

Charlotte, NC 64 

Chicago, IL 169 

Cincinnati, OH 39 

Cleveland, OH 61 

Columbus, OH 27 

Corpus Christi, TX 0 

Dallas, TX 113 

Dayton, OH 96 

Denver, CO 6 

Des Moines, IA 5 

Detroit, MI 40 

El Paso, TX 3 

Fort Worth, TX 41 

Honolulu, HI 1 

Houston, TX 84 

Indianapolis, IN 48 

Jacksonville, FL 38 

Jersey City, NJ 3 

Kansas City, MO 2 

Los Angeles, CA 86 

Louisville, KY 57 

Memphis, TN 199 

Miami, FL 14 

Milwaukee, WI 76 

Minneapolis, MN 2 

Nashville, TN 97 

New Orleans, LA 70 

New York City, NY 61 

Newark, NJ 14 

Norfolk, VA 51 

Oakland, CA 3 

Oklahoma City, OK 51 

Omaha, NE 1 

Philadelphia, PA 51 

Phoenix, AZ 35 

Pittsburgh, PA 0 

Portland, OR 3 

Richmond, VA 31 

Rochester, NY 6 

Sacramento, CA 2 

San Antonio, TX 16 

San Diego, CA 11 

San Francisco, CA 3 

San Jose, CA 0 

Seattle, WA 0 

St Louis, MO 66 

St Paul, MN 0 

St Petersburg, FL 2 

Tampa, FL 22 

Toledo, OH 17 

Tucson, AZ 5 

Tulsa, OK 14 

Washington, DC 57 

Wichita, KS 6 

Yonkers, NY 0 

2 

5 

67 

3 

309 

43 

19 

1 

18 

145 

13 

27 

30 

0 

66 

15 

3 

0 

45 

0 

12 

0 

84 

36 

12 

5 

1 

32 

51 

165 

16 

46 

3 

97 

57 

37 

12 

25 

0 

15 

0 

43 

31 

4 

1 

21 

1 

2 

12 

5 

8 

0 

6 

36 

0 

7 

21 

3 

5 

4 

58 

4 

0 

1 

6 

62 

6 

222 

15 

5 

1 

36 

132 

8 

15 

32 

0 

46 

3 

2 

0 

67 

0 

9 

0 

44 

87 

8 

0 

2 

50 

45 

134 

11 

35 

2 

93 

41 

18 

14 

13 

5 

26 

1 

30 

64 

0 

1 

8 

4 

0 

8 

7 

4 

1 

1 

25 

2 

4 

20 

4 

1 

6 

34 

1 

1 

0 

3 

85 

2 

112 

10 

5 

0 

18 

116 

0 

3 

21 

1 

57 

0 

3 

0 

74 

2 

4 

2 

30 

204 

3 

0 

5 

25 

30 

126 

24 

17 

3 

102 

24 

28 

10 

7 

2 

42 

2 

21 

62 

0 

3 

7 

0 

1 

10 

6 

1 

0 

2 

28 

1 

2 

7 

5 

1 

22 

24 

4 

0 

0 

3 

37 

2 

92 

15 

5 

1 

24 

129 

0 

2 

14 

1 

36 

1 

0 

1 

121 

1 

7 

0 

27 

170 

11 

1 

0 

19 

26 

123 

40 

21 

3 

83 

8 

10 

9 

14 

3 

39 

1 

25 

75 

2 

4 

2 

0 

1 

23 

6 

5 

0 

4 

3 

1 

3 

10 

0 

2 

4 

10 

1 

0 

U.S. CITY TOTAL 2,398 1,789 1,523 1,409 1,281 

San Juan, PR 38 41 38 34 32 

TOTAL 2,436 1,830 1,561 1,443 1,313 

Rates per 100,000 Population 

1996 1997 1998 1999 2000 

0.0 

0.4 

23.1 

1.8 

66.9 

23.0 

4.8 

0.6 

20.7 

11.2 

8.7 

8.3 

5.2 

0.0 

11.2 

32.6 

2.4 

2.7 

7.0 

0.9 

6.2 

0.2 

5.4 

11.2 

10.2 

2.7 

0.9 

2.0 

16.1 

44.0 

1.3 

15.8 

1.0 

34.8 

27.5 

1.6 

9.3 

45.1 

0.5 

22.5 

0.4 

6.5 

2.6 

0.0 

1.2 

29.7 

4.8 

0.4 

2.4 

0.8 

0.8 

0.0 

0.0 

34.8 

0.0 

0.4 

4.8 

7.2 

1.3 

7.1 

19.9 

2.7 

0.0 

0.7 0.4 0.0 0.0 

1.9 2.2 1.1 1.1 

17.8 16.0 21.8 9.5 

0.9 1.7 0.5 0.5 

87.9 64.4 33.2 27.3 

12.3 4.3 2.9 4.3 

6.6 1.7 1.7 1.7 

0.6 0.6 0.0 0.6 

5.7 11.0 5.3 7.1 

9.6 8.5 7.5 8.3 

2.9 1.8 0.0 0.0 

3.7 2.1 0.4 0.3 

5.7 6.0 3.9 2.6 

0.0 0.0 0.6 0.6 

6.4 4.4 5.4 3.4 

5.1 1.0 0.0 0.3 

1.2 0.8 1.2 0.0 

0.0 0.0 0.0 0.5 

7.9 10.1 11.2 18.3 

0.0 0.0 0.5 0.3 

1.8 1.3 0.6 1.0 

0.0 0.0 0.5 0.0 

5.3 2.7 1.8 1.6 

8.5 20.4 48.0 40.0 

3.2 2.1 0.8 2.9 

4.5 0.0 0.0 0.9 

0.4 0.8 2.1 0.0 

0.7 1.1 0.6 0.4 

14.5 12.7 8.4 7.3 

36.4 29.4 27.5 26.8 

1.5 1.0 2.1 3.5 

9.7 7.3 3.6 4.4 

1.5 1.1 1.6 1.6 

34.7 33.1 36.6 29.8 

22.7 16.4 9.7 3.2 

1.0 0.5 0.7 0.3 

8.0 9.4 6.7 6.0 

22.5 11.9 6.4 12.8 

0.0 0.8 0.3 0.5 

6.6 12.3 19.7 18.3 

0.0 0.4 0.9 0.4 

5.5 3.9 2.8 3.3 

2.3 4.5 4.3 5.2 

0.6 0.0 0.0 0.3 

0.4 0.4 1.2 1.6 

20.0 7.5 6.7 1.9 

0.8 3.2 0.0 0.0 

0.3 0.0 0.2 0.2 

1.7 1.1 1.4 3.2 

0.4 0.5 0.4 0.4 

2.2 1.1 0.3 1.3 

0.0 0.1 0.0 0.0 

0.7 0.1 0.2 0.5 

19.4 13.6 15.5 1.7 

0.0 1.4 0.7 0.7 

1.5 0.9 0.4 0.6 

4.5 4.2 1.4 2.1 

1.3 1.7 2.1 0.0 

1.3 0.2 0.2 0.5 

2.0 3.0 11.1 2.0 

20.7 12.2 8.7 3.6 

1.8 0.4 1.7 0.4 

0.0 1.0 0.0 0.0 

6.7 5.0 4.2 3.8 3.5 

7.9 8.5 7.0 6.2 5.9 

6.7 5.0 4.2 3.9 3.5 

STD Surveillance 2000 Syphilis Tables 111 
Table 31. Primary and secondary syphilis — Men – Reported cases and rates in selected cities of >200,000 

population listed in alphabetical order: United States and outlying areas, 1996–2000 

Cases 

City 1996 1997 1998 1999 

Akron, OH 0 

Albuquerque, NM 1 

Atlanta, GA 161 

Austin, TX 3 

Baltimore, MD 313 

Birmingham, AL 121 

Boston, MA 28 

Buffalo, NY 5 

Charlotte, NC 71 

Chicago, IL 174 

Cincinnati, OH 37 

Cleveland, OH 69 

Columbus, OH 27 

Corpus Christi, TX 0 

Dallas, TX 123 

Dayton, OH 105 

Denver, CO 5 

Des Moines, IA 1 

Detroit, MI 52 

El Paso, TX 7 

Fort Worth, TX 54 

Honolulu, HI 2 

Houston, TX 67 

Indianapolis, IN 37 

Jacksonville, FL 37 

Jersey City, NJ 7 

Kansas City, MO 5 

Los Angeles, CA 127 

Louisville, KY 47 

Memphis, TN 198 

Miami, FL 24 

Milwaukee, WI 82 

Minneapolis, MN 2 

Nashville, TN 96 

New Orleans, LA 99 

New York City, NY 77 

Newark, NJ 11 

Norfolk, VA 41 

Oakland, CA 7 

Oklahoma City, OK 63 

Omaha, NE 1 

Philadelphia, PA 90 

Phoenix, AZ 54 

Pittsburgh, PA 2 

Portland, OR 4 

Richmond, VA 35 

Rochester, NY 7 

Sacramento, CA 4 

San Antonio, TX 9 

San Diego, CA 25 

San Francisco, CA 30 

San Jose, CA 3 

Seattle, WA 1 

St Louis, MO 76 

St Paul, MN 3 

St Petersburg, FL 6 

Tampa, FL 22 

Toledo, OH 13 

Tucson, AZ 5 

Tulsa, OK 26 

Washington, DC 59 

Wichita, KS 9 

Yonkers, NY 0 

2 

4 

137 

5 

359 

64 

33 

1 

30 

201 

21 

34 

24 

2 

82 

13 

5 

0 

49 

3 

27 

1 

96 

35 

24 

4 

1 

76 

56 

178 

33 

38 

9 

106 

75 

60 

14 

19 

7 

24 

1 

65 

87 

1 

2 

28 

1 

2 

15 

18 

44 

5 

5 

28 

0 

4 

13 

3 

7 

4 

59 

12 

2 

2 

5 

101 

9 

244 

21 

18 

3 

33 

206 

4 

15 

23 

0 

80 

3 

1 

3 

85 

2 

17 

4 

55 

78 

8 

1 

4 

70 

46 

126 

20 

36 

2 

117 

64 

63 

13 

20 

6 

35 

3 

59 

109 

0 

3 

14 

3 

1 

18 

17 

21 

2 

32 

33 

1 

4 

12 

4 

6 

8 

47 

2 

0 

0 

8 

128 

16 

134 

14 

11 

1 

35 

166 

1 

9 

22 

0 

94 

2 

1 

0 

115 

7 

18 

1 

47 

203 

4 

3 

3 

57 

37 

132 

58 

22 

3 

148 

27 

102 

12 

13 

8 

72 

3 

48 

133 

2 

2 

6 

0 

1 

20 

19 

28 

3 

63 

23 

1 

2 

8 

1 

7 

23 

21 

3 

1 

2000 

0 

8 

79 

6 

126 

9 

20 

0 

21 

163 

0 

2 

26 

0 

64 

4 

4 

0 

153 

5 

15 

1 

43 

131 

13 

0 

1 

112 

31 

123 

86 

22 

6 

117 

14 

107 

19 

23 

8 

43 

1 

42 

97 

1 

7 

3 

1 

0 

44 

21 

48 

2 

46 

8 

1 

4 

10 

2 

6 

4 

27 

1 

1 

U.S. CITY TOTAL 2,870 2,358 2,042 2,152 1,982 

San Juan, PR 36 58 41 27 36 

TOTAL 2,906 2,416 2,083 2,179 2,018 

Rates per 100,000 Population 

1996 1997 1998 1999 2000 

0.0 

0.4 

47.1 

0.9 

100.1 

39.1 

10.4 

3.2 

24.7 

12.4 

9.1 

10.5 

5.5 

0.0 

12.5 

38.7 

2.1 

0.6 

10.0 

2.1 

8.4 

0.5 

4.3 

9.5 

10.5 

6.6 

2.4 

3.0 

14.8 

48.0 

2.5 

18.8 

1.1 

37.8 

45.0 

2.2 

8.1 

34.3 

1.1 

29.8 

0.5 

13.2 

4.2 

0.3 

1.7 

40.4 

6.0 

0.7 

1.4 

1.9 

8.3 

0.4 

0.1 

47.7 

2.3 

1.5 

5.0 

6.0 

1.3 

14.1 

23.4 

4.2 

0.0 

0.8 0.8 0.0 0.0 

1.6 2.0 3.1 3.1 

39.6 28.6 36.0 22.2 

1.4 2.5 4.4 1.7 

117.4 81.0 45.4 42.7 

20.8 6.8 4.6 2.9 

12.3 6.7 4.1 7.5 

0.7 2.0 0.7 0.0 

10.1 10.9 11.2 6.7 

14.3 14.4 11.6 11.4 

5.2 1.0 0.3 0.0 

5.2 2.3 1.4 0.3 

4.9 4.7 4.4 5.3 

1.3 0.0 0.0 0.0 

8.2 7.9 9.3 6.3 

4.8 1.1 0.7 1.5 

2.1 0.4 0.4 1.6 

0.0 1.7 0.0 0.0 

9.5 14.2 19.4 25.8 

0.9 0.6 2.1 1.5 

4.1 2.5 2.6 2.2 

0.2 0.9 0.2 0.2 

6.1 3.5 2.9 2.7 

9.0 20.2 52.7 34.0 

6.8 2.2 1.1 3.6 

3.8 0.9 2.8 0.0 

0.5 1.9 1.4 0.5 

1.8 1.6 1.3 2.6 

17.6 14.5 11.6 9.8 

43.1 30.5 31.8 29.6 

3.4 1.9 5.6 8.3 

8.8 8.3 5.1 5.1 

4.8 1.1 1.7 3.4 

41.7 46.2 58.9 46.5 

34.5 29.7 12.6 6.6 

1.7 1.8 2.9 3.1 

10.4 9.7 8.9 14.2 

16.1 18.9 11.2 19.7 

1.1 1.0 1.3 1.3 

11.3 17.9 36.6 21.8 

0.5 1.4 1.4 0.5 

9.6 8.9 7.3 6.4 

6.5 7.9 9.4 6.9 

0.2 0.0 0.3 0.2 

0.8 1.2 0.8 2.9 

32.1 16.0 7.0 3.5 

0.9 2.6 0.0 0.9 

0.4 0.2 0.2 0.0 

2.3 2.8 3.0 6.6 

1.3 1.2 1.3 1.5 

12.2 5.7 7.6 13.0 

0.6 0.2 0.4 0.2 

0.6 3.9 7.7 5.6 

17.9 21.2 15.0 5.2 

0.0 0.8 0.8 0.8 

1.0 1.0 0.5 1.0 

2.9 2.7 1.7 2.2 

1.4 1.9 0.5 0.9 

1.8 1.6 1.8 1.5 

2.1 4.4 12.4 2.2 

23.8 19.2 8.6 11.1 

5.6 0.9 1.4 0.5 

2.2 0.0 1.1 1.1 

8.5 7.0 6.0 6.3 5.8 

9.2 14.8 8.2 5.3 7.1 

8.5 7.1 6.0 6.2 5.8 

112 Syphilis Tables STD Surveillance 2000 
This page intentionally left blank.
 
Table 32A. Primary and secondary syphilis — Reported cases by age, gender, and race/ethnicity: United States, 

1996–2000 

Age 

Group Total 

Total 

Male Female 

White, Non-Hispanic 

Total Male Female 

Black, Non-Hispanic 

Total Male Female Total 

Hispanic 

Male Female 

Asian/Pacific Islander 

Total Male Female 

American Indian/ 

Alaska Native 

Total Male Female 

10-14 49 6 43 3 0 3 43 6 37 3 0 3 0 0 0 0 0 0 

15-19 1,127 388 739 108 28 80 967 340 628 44 18 26 5 1 4 2 1 1 

20-24 1,936 877 1,059 162 41 121 1,647 764 884 106 65 41 13 5 8 7 2 5 

1996

25-29 

30-34 

35-39 

1,893 

2,005 

1,856 

921 

1,028 

1,022 

972 

977 

834 

211 99 112 

198 104 95 

202 106 96 

1,565 740 825 

1,705 854 851 

1,564 854 710 

101 

86 

79 

72 

63 

55 

29 

23 

24 

10 6 4 

6 3 3 

6 4 2 

6 4 2 

9 4 5 

4 2 2 

40-44 1,124 704 420 110 64 45 963 606 357 40 30 10 5 3 2 5 0 5 

45-54 972 717 255 131 97 34 797 586 210 33 23 11 3 3 0 8 8 0 

55-64 282 235 47 56 49 7 210 172 37 17 14 2 0 0 0 0 0 0 

65+ 108 94 14 18 18 0 78 66 12 9 7 2 2 2 0 0 0 0 

TOTAL 11,365 5,997 5,368 1,201 607 594 9,550 4,992 4,558 519 348 172 52 29 24 42 22 21 

10-14 43 4 39 4 0 4 36 3 33 3 1 2 0 0 0 0 0 0 

15-19 778 255 523 70 16 54 649 214 435 55 24 31 3 1 2 1 0 1 

20-24 1,319 620 699 110 44 66 1,116 518 598 80 54 27 6 1 5 7 3 4 

1997

25-29 

30-34 

35-39 

1,435 

1,477 

1,407 

721 

761 

780 

714 

716 

627 

142 66 76 

161 73 88 

196 100 97 

1,180 569 611 

1,229 632 597 

1,153 639 514 

102 

74 

50 

77 

52 

38 

26 

23 

12 

4 4 0 

7 3 4 

3 2 1 

7 5 2 

6 2 4 

5 2 3 

40-44 944 628 317 107 75 32 787 522 265 38 24 14 5 2 3 7 5 2 

45-54 771 565 205 107 82 26 622 456 166 30 20 10 4 2 2 7 5 2 

55-64 256 224 32 52 44 8 186 162 24 17 17 0 0 0 0 0 0 0 

65+ 107 99 8 25 24 1 74 67 7 9 9 0 0 0 0 0 0 0 

TOTAL 8,549 4,661 3,888 975 523 453 7,041 3,786 3,255 459 315 145 33 15 17 41 23 18 

10-14 39 5 34 4 0 4 34 5 29 1 0 1 0 0 0 0 0 0 

15-19 612 193 418 54 11 43 504 163 342 43 16 27 3 0 3 7 3 4 

20-24 1,029 509 521 105 30 75 835 418 417 73 52 21 5 3 2 11 6 5 

1998

25-29 

30-34 

35-39 

1,028 

1,179 

1,178 

508 

626 

683 

520 

553 

494 

130 50 79 

146 77 69 

172 104 68 

782 383 398 

949 484 465 

927 523 404 

100 

65 

65 

65 

54 

46 

35 

11 

18 

5 4 1 

9 7 2 

7 6 1 

12 5 7 

9 4 5 

7 4 3 

40-44 831 533 298 129 95 35 653 404 250 40 30 10 3 2 1 5 3 2 

45-54 780 577 203 123 102 20 610 439 171 45 35 10 1 1 0 1 0 1 

55-64 232 194 37 51 48 3 161 129 32 16 14 2 2 2 0 2 2 0 

65+ 102 86 16 21 18 3 71 60 11 9 7 2 0 0 0 1 1 0 

TOTAL 7,018 3,918 3,100 936 536 400 5,534 3,009 2,524 457 319 138 36 26 10 56 29 28 

10-14 25 2 23 3 1 2 21 1 20 1 0 1 0 0 0 0 0 0 

15-19 522 182 340 49 16 32 421 139 282 44 24 19 1 1 0 8 2 6 

20-24 963 510 452 120 46 74 717 381 336 110 75 35 5 3 2 10 5 5 

1999

25-29 

30-34 

35-39 

991 

1,084 

1,153 

508 

589 

677 

482 

496 

476 

137 67 70 

168 98 70 

189 112 77 

741 364 376 

801 411 390 

883 501 382 

94 

97 

69 

67 

73 

56 

26 

24 

12 

7 7 0 

12 6 6 

4 4 0 

11 2 9 

6 1 5 

8 3 5 

40-44 808 538 271 142 98 44 601 390 211 56 46 9 8 3 4 2 0 2 

45-54 753 572 181 139 96 43 561 430 130 42 36 6 5 5 0 6 4 2 

55-64 228 188 40 53 41 12 151 129 22 22 16 5 1 0 1 1 1 0 

65+ 74 65 9 24 22 2 46 39 7 4 4 0 0 0 0 0 0 0 

TOTAL 6,612 3,833 2,779 1,026 598 428 4,950 2,788 2,163 538 399 139 43 30 13 54 18 36 

10-14 23 4 19 2 0 2 20 4 16 0 0 0 0 0 0 1 0 1 

15-19 457 162 295 47 11 35 365 129 236 41 21 19 1 0 1 4 1 3 

20-24 881 419 462 110 40 70 653 310 344 101 66 35 4 1 3 13 3 10 

2000

25-29 

30-34 

35-39 

900 

957 

1,006 

525 

553 

606 

375 

404 

400 

145 92 53 

182 119 62 

216 143 72 

630 337 292 

665 350 314 

664 374 291 

108 

94 

113 

81 

72 

81 

26 

22 

32 

8 7 1 

12 10 2 

5 4 1 

9 7 2 

5 2 3 

7 3 4 

40-44 782 502 280 173 118 55 550 341 209 51 38 13 2 2 0 5 3 2 

45-54 706 528 178 145 114 31 511 375 136 43 32 11 4 4 0 4 4 0 

55-64 179 157 22 42 40 2 124 106 18 11 10 1 0 0 0 2 1 1 

65+ 76 68 8 21 19 2 50 44 6 3 3 0 1 1 0 1 1 0 

TOTAL 5,970 3,526 2,444 1,083 698 385 4,231 2,368 1,863 566 405 162 37 29 8 52 26 26 

NOTE: These tables should be used only for race/ethnicity and age comparisons, not for overall totals or gender totals. This is because, if age or race/ethnicity was not specified, cases were prorated according to the distribution of cases for which these variables were specified. For the following years, the 

states listed did not report race/ethnicity for most cases and were excluded: 1996 (RI); 1999 (NH). Differences between total cases from this table and others in the report are due to different reporting forms and above exclusions. The 0 to 9 year age group is not shown because some of these may not be 

due to sexual transmission; however, they are included in the totals. 

114 Syphilis Tables STD Surveillance 2000 
Table 32B. Primary and secondary syphilis — Reported rates per 100,000 population by age, gender, and 

race/ethnicity: United States, 1996–2000 

Age 

Group Total 

Total 

Male Female 

White, Non-Hispanic 

Total Male Female 

Black, Non-Hispanic 

Total Male Female Total 

Hispanic 

Male Female 

Asian/Pacific Islander 

Total Male Female 

American Indian/ 

Alaska Native 

Total Male Female 

10-14 0.3 0.1 0.5 0.0 0.0 0.1 1.5 0.4 2.7 0.1 0.0 0.3 0.0 0.0 0.0 0.0 0.0 0.0 

15-19 6.1 4.1 8.2 0.9 0.4 1.3 35.0 24.3 46.1 1.8 1.4 2.2 0.8 0.3 1.3 1.2 1.2 1.2 

20-24 11.1 9.8 12.4 1.4 0.7 2.1 66.9 62.9 70.8 4.3 4.8 3.7 1.9 1.5 2.3 4.7 2.7 6.7 

25-29 

30-34 

35-39 

10.0 

9.4 

8.3 

9.7 

9.7 

9.1 

10.3 

9.2 

7.4 

1.6 1.5 1.7 

1.3 1.4 1.3 

1.2 1.3 1.2 

63.6 63.2 64.0 

64.2 68.9 60.1 

58.1 67.9 49.5 

4.0 

3.3 

3.4 

5.2 

4.5 

4.6 

2.5 

1.9 

2.2 

1.3 1.6 1.0 

0.8 0.8 0.7 

0.8 1.1 0.5 

4.1 5.5 2.7 

1996

6.1 5.7 6.6 

2.7 2.8 2.6 

40-44 5.4 6.9 4.0 0.7 0.8 0.6 40.7 55.3 28.1 2.2 3.2 1.1 0.7 0.9 0.5 3.7 0.0 7.1 

45-54 3.0 4.5 1.5 0.5 0.8 0.3 24.4 39.7 11.7 1.4 1.9 0.9 0.3 0.6 0.0 3.7 7.7 0.0 

55-64 1.3 2.3 0.4 0.3 0.6 0.1 10.1 19.2 3.2 1.1 2.1 0.3 0.0 0.0 0.0 0.0 0.0 0.0 

65+ 0.3 0.7 0.1 0.1 0.2 0.0 2.9 6.4 0.7 0.6 1.1 0.2 0.3 0.8 0.0 0.0 0.0 0.0 

TOTAL 4.3 4.6 4.0 0.6 0.6 0.6 29.9 33.1 27.1 1.8 2.4 1.2 0.6 0.7 0.5 2.2 2.2 2.1 

10-14 0.2 0.0 0.4 0.0 0.0 0.1 1.3 0.2 2.4 0.1 0.1 0.2 0.0 0.0 0.0 0.0 0.0 0.0 

15-19 4.1 2.6 5.7 0.5 0.2 0.9 23.0 14.9 31.3 2.1 1.7 2.6 0.4 0.3 0.6 0.5 0.0 1.1 

20-24 7.5 6.9 8.2 0.9 0.7 1.2 45.2 42.6 47.9 3.1 3.8 2.3 0.9 0.3 1.4 4.6 3.9 5.3 

25-29 

30-34 

35-39 

7.6 

7.1 

6.2 

7.6 

7.4 

6.9 

7.6 

6.9 

5.5 

1.1 1.0 1.2 

1.1 1.0 1.2 

1.2 1.2 1.2 

47.6 48.2 47.1 

47.1 51.8 42.9 

42.4 50.3 35.5 

4.0 

2.8 

2.1 

5.5 

3.6 

3.0 

2.2 

1.8 

1.1 

0.5 1.0 0.0 

0.9 0.8 0.9 

0.4 0.5 0.2 

4.6 6.4 2.7 

1997

4.1 2.7 5.4 

3.3 2.7 3.9 

40-44 4.4 5.9 2.9 0.7 0.9 0.4 31.9 45.5 20.1 1.9 2.4 1.5 0.6 0.6 0.7 5.0 7.4 2.7 

45-54 2.3 3.4 1.2 0.4 0.6 0.2 18.1 29.5 8.8 1.2 1.5 0.8 0.4 0.4 0.3 3.4 5.1 1.9 

55-64 1.2 2.2 0.3 0.3 0.5 0.1 8.7 17.6 2.0 1.2 2.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

65+ 0.3 0.7 0.0 0.1 0.2 0.0 2.7 6.3 0.4 0.5 1.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

TOTAL 3.2 3.6 2.8 0.5 0.5 0.5 21.8 24.8 19.1 1.6 2.1 1.0 0.3 0.3 0.4 2.1 2.3 1.8 

10-14 0.2 0.1 0.4 0.0 0.0 0.1 1.2 0.3 2.1 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 

15-19 3.1 1.9 4.4 0.4 0.2 0.7 17.5 11.2 24.1 1.6 1.2 2.0 0.4 0.0 0.8 3.7 3.2 4.3 

20-24 5.8 5.7 6.0 0.9 0.5 1.3 33.4 33.9 33.0 2.8 3.8 1.7 0.7 0.9 0.6 7.1 7.7 6.5 

25-29 

30-34 

35-39 

5.5 

5.8 

5.2 

5.5 

6.3 

6.1 

5.6 

5.4 

4.3 

1.0 0.8 1.3 

1.0 1.1 1.0 

1.1 1.3 0.8 

31.4 32.3 30.6 

36.9 40.3 33.9 

33.9 40.9 27.7 

3.9 

2.5 

2.6 

5.0 

3.9 

3.6 

2.8 

0.9 

1.5 

0.6 1.0 0.2 

1.1 1.8 0.4 

0.8 1.5 0.2 

7.7 6.3 9.1 

1998

6.2 5.5 6.9 

4.6 5.3 3.9 

40-44 3.8 4.9 2.7 0.8 1.2 0.4 25.6 34.0 18.3 1.9 2.9 1.0 0.4 0.5 0.2 3.5 4.4 2.7 

45-54 2.3 3.4 1.1 0.5 0.8 0.2 17.0 27.2 8.7 1.6 2.6 0.7 0.1 0.2 0.0 0.5 0.0 0.9 

55-64 1.0 1.8 0.3 0.3 0.5 0.0 7.3 13.6 2.6 1.0 1.9 0.2 0.3 0.6 0.0 1.6 3.3 0.0 

65+ 0.3 0.6 0.1 0.1 0.1 0.0 2.6 5.6 0.7 0.5 1.0 0.2 0.0 0.0 0.0 0.7 1.7 0.0 

TOTAL 2.6 3.0 2.2 0.5 0.6 0.4 16.9 19.4 14.6 1.5 2.1 0.9 0.4 0.5 0.2 2.8 2.9 2.7 

10-14 0.1 0.0 0.2 0.0 0.0 0.0 0.7 0.1 1.4 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 

15-19 2.7 1.8 3.6 0.4 0.2 0.5 14.6 9.4 19.8 1.6 1.7 1.4 0.1 0.3 0.0 4.2 2.1 6.4 

20-24 5.4 5.6 5.1 1.0 0.8 1.3 28.0 30.2 26.0 4.1 5.4 2.7 0.7 0.9 0.6 6.5 6.4 6.6 

25-29 

30-34 

35-39 

5.5 

5.5 

5.1 

5.6 

6.1 

6.1 

5.3 

5.0 

4.2 

1.1 1.1 1.2 

1.2 1.5 1.0 

1.2 1.4 1.0 

29.9 30.9 29.1 

31.8 34.9 29.1 

32.2 39.0 26.1 

3.6 

3.6 

2.7 

5.1 

5.3 

4.2 

2.1 

1.9 

1.0 

0.9 1.9 0.0 

1.3 1.5 1.2 

0.5 1.0 0.0 

7.2 2.5 12.0 

1999

4.3 1.4 7.1 

5.3 4.0 6.7 

40-44 3.6 4.9 2.4 0.9 1.2 0.5 23.0 31.9 15.1 2.6 4.2 0.9 0.9 0.8 1.0 1.4 0.0 2.8 

45-54 2.1 3.3 1.0 0.5 0.7 0.3 14.9 25.3 6.3 1.4 2.5 0.4 0.4 0.8 0.0 2.8 3.8 1.8 

55-64 1.0 1.7 0.3 0.3 0.5 0.1 6.7 13.3 1.7 1.3 2.1 0.6 0.2 0.0 0.3 0.8 1.6 0.0 

65+ 0.2 0.5 0.0 0.1 0.2 0.0 1.7 3.6 0.4 0.2 0.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

TOTAL 2.4 2.9 2.0 0.5 0.6 0.4 15.0 17.8 12.4 1.7 2.5 0.9 0.4 0.6 0.3 2.7 1.9 3.5 

10-14 0.1 0.0 0.2 0.0 0.0 0.0 0.7 0.3 1.1 0.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 1.0 

15-19 2.3 1.6 3.1 0.4 0.2 0.6 12.6 8.8 16.6 1.5 1.5 1.4 0.1 0.0 0.3 2.1 1.0 3.1 

20-24 4.9 4.6 5.2 0.9 0.7 1.2 25.6 24.5 26.6 3.8 4.7 2.7 0.6 0.3 0.8 8.2 3.8 12.6 

25-29 

30-34 

35-39 

4.9 

4.9 

4.5 

5.8 

5.7 

5.4 

4.1 

4.1 

3.5 

1.2 1.5 0.9 

1.3 1.8 0.9 

1.3 1.8 0.9 

25.4 28.5 22.6 

26.4 29.7 23.4 

24.2 29.0 19.9 

4.2 

3.6 

4.4 

6.2 

5.2 

6.1 

2.1 

1.7 

2.5 

1.0 1.8 0.2 

1.3 2.3 0.4 

0.6 1.0 0.2 

5.8 8.9 2.6 

2000

3.5 2.8 4.1 

4.6 4.0 5.2 

40-44 3.5 4.6 2.5 1.1 1.4 0.7 21.0 27.9 15.0 2.4 3.5 1.2 0.2 0.5 0.0 3.5 4.3 2.7 

45-54 2.0 3.0 1.0 0.5 0.8 0.2 13.6 22.1 6.6 1.5 2.2 0.7 0.3 0.7 0.0 1.8 3.8 0.0 

55-64 0.8 1.4 0.2 0.2 0.4 0.0 5.5 10.9 1.4 0.7 1.3 0.1 0.0 0.0 0.0 1.5 1.6 1.4 

65+ 0.2 0.5 0.0 0.1 0.2 0.0 1.8 4.0 0.4 0.2 0.4 0.0 0.1 0.3 0.0 0.7 1.6 0.0 

TOTAL 2.2 2.6 1.8 0.6 0.7 0.4 12.8 15.1 10.7 1.8 2.6 1.0 0.4 0.6 0.2 2.6 2.6 2.6 

NOTE: These tables should be used only for race/ethnicity and age comparisons, not for overall totals or gender totals. This is because, if age or race/ethnicity was not specified, cases were prorated according to the distribution of cases for which these variables were specified. For the following years, the 

states listed did not report race/ethnicity for most cases and were excluded: 1996 (RI); 1999 (NH). Differences between total cases from this table and others in the report are due to different reporting forms and above exclusions. The 0 to 9 year age group is not shown because some of these may not be 

due to sexual transmission; however, they are included in the totals. 

STD Surveillance 2000 Syphilis Tables 115 
Table 33. Early latent syphilis — Reported cases and rates by state/area listed in alphabetical order: United 

States and outlying areas, 1996–2000 

Cases Rates per 100,000 Population 

State/Area 1996 1997 1998 1999 2000 1996 1997 1998 1999 2000 

Alabama 801 623 440 367 219 18.7 14.4 10.1 8.4 5.0 

Alaska 0 0 0 1 1 0.0 0.0 0.0 0.2 0.2 

Arizona 129 201 206 290 248 2.9 4.4 4.4 6.1 5.2 

Arkansas 446 237 185 123 117 17.8 9.4 7.3 4.8 4.6 

California 1,148 961 783 591 353 3.6 3.0 2.4 1.8 1.1 

Colorado 21 13 10 6 7 0.6 0.3 0.3 0.1 0.2 

Connecticut 104 86 37 12 9 3.2 2.6 1.1 0.4 0.3 

Delaware 40 37 44 16 10 5.5 5.1 5.9 2.1 1.3 

Florida 1,323 1,179 1,092 1,085 1,165 9.2 8.0 7.3 7.2 7.7 

Georgia 1,304 1,085 740 729 521 17.8 14.5 9.7 9.4 6.7 

Hawaii 2 0 0 1 3 0.2 0.0 0.0 0.1 0.3 

Idaho 5 5 0 1 0 0.4 0.4 0.0 0.1 0.0 

Illinois 917 1,032 641 640 387 7.7 8.7 5.3 5.3 3.2 

Indiana 265 169 121 172 184 4.5 2.9 2.1 2.9 3.1 

Iowa 38 27 20 4 8 1.3 0.9 0.7 0.1 0.3 

Kansas 46 58 39 19 9 1.8 2.2 1.5 0.7 0.3 

Kentucky 126 122 101 81 62 3.2 3.1 2.6 2.0 1.6 

Louisiana 959 550 446 404 231 22.1 12.6 10.2 9.2 5.3 

Maine 2 2 0 0 0 0.2 0.2 0.0 0.0 0.0 

Maryland 1,152 1,218 848 610 518 22.8 23.9 16.5 11.8 10.0 

Massachusetts 178 127 104 65 83 2.9 2.1 1.7 1.1 1.3 

Michigan 413 354 261 302 406 4.2 3.6 2.7 3.1 4.1 

Minnesota 29 21 8 9 18 0.6 0.4 0.2 0.2 0.4 

Mississippi 1,484 962 650 553 409 54.7 35.2 23.6 20.0 14.8 

Missouri 259 202 165 99 52 4.8 3.7 3.0 1.8 1.0 

Montana 4 4 0 2 0 0.5 0.5 0.0 0.2 0.0 

Nebraska 5 5 3 6 1 0.3 0.3 0.2 0.4 0.1 

Nevada 32 24 38 28 9 2.0 1.4 2.2 1.5 0.5 

New Hampshire 3 0 1 1 0 0.3 0.0 0.1 0.1 0.0 

New Jersey 303 236 231 99 109 3.8 2.9 2.8 1.2 1.3 

New Mexico 5 8 8 2 25 0.3 0.5 0.5 0.1 1.4 

New York 1,203 763 679 700 467 6.6 4.2 3.7 3.8 2.6 

North Carolina 1,071 879 846 740 618 14.7 11.8 11.2 9.7 8.1 

North Dakota 0 0 0 0 1 0.0 0.0 0.0 0.0 0.2 

Ohio 508 331 227 168 119 4.6 3.0 2.0 1.5 1.1 

Oklahoma 216 179 158 249 128 6.6 5.4 4.7 7.4 3.8 

Oregon 9 14 7 6 19 0.3 0.4 0.2 0.2 0.6 

Pennsylvania 883 668 424 414 278 7.3 5.6 3.5 3.5 2.3 

Rhode Island 8 7 0 1 1 0.8 0.7 0.0 0.1 0.1 

South Carolina 581 481 383 407 394 15.6 12.8 10.0 10.5 10.1 

South Dakota 0 2 0 1 0 0.0 0.3 0.0 0.1 0.0 

Tennessee 957 984 659 647 627 18.0 18.3 12.1 11.8 11.4 

Texas 2,167 1,863 1,480 1,273 1,171 11.4 9.6 7.5 6.4 5.8 

Utah 8 2 3 5 10 0.4 0.1 0.1 0.2 0.5 

Vermont 0 0 2 0 0 0.0 0.0 0.3 0.0 0.0 

Virginia 406 379 230 212 140 6.1 5.6 3.4 3.1 2.0 

Washington 5 13 16 17 20 0.1 0.2 0.3 0.3 0.3 

West Virginia 8 1 2 3 3 0.4 0.1 0.1 0.2 0.2 

Wisconsin 243 169 115 90 72 4.7 3.3 2.2 1.7 1.4 

Wyoming 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

U.S. TOTAL1 20,187 16,631 12,741 11,535 9,470 7.6 6.2 4.7 4.2 3.5 

Guam 0 0 0 0 1 0.0 0.0 0.0 0.0 0.6 

Puerto Rico 631 679 659 680 663 17.0 17.7 17.1 17.5 17.0 

Virgin Islands 6 8 28 12 5 5.5 7.3 25.5 10.6 4.4 

OUTLYING AREAS 637 687 687 692 669 16.0 16.8 16.6 16.6 16.1 

TOTAL 20,824 17,318 13,428 12,227 10,139 7.7 6.4 4.9 4.4 3.7 

1

Includes cases reported by Washington, D.C. 

116 Syphilis Tables STD Surveillance 2000 
Table 34. Early latent syphilis — Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1996–2000 

Cases 

City 1996 1997 1998 1999 2000 

Akron, OH 4 

Albuquerque, NM 0 

Atlanta, GA 383 

Austin, TX 49 

Baltimore, MD 896 

Birmingham, AL 341 

Boston, MA 83 

Buffalo, NY 6 

Charlotte, NC 144 

Chicago, IL 745 

Cincinnati, OH 43 

Cleveland, OH 202 

Columbus, OH 32 

Corpus Christi, TX 10 

Dallas, TX 335 

Dayton, OH 93 

Denver, CO 7 

Des Moines, IA 23 

Detroit, MI 271 

El Paso, TX 44 

Fort Worth, TX 216 

Honolulu, HI 0 

Houston, TX 703 

Indianapolis, IN 56 

Jacksonville, FL 104 

Jersey City, NJ 17 

Kansas City, MO 13 

Los Angeles, CA 718 

Louisville, KY 71 

Memphis, TN 548 

Miami, FL 437 

Milwaukee, WI 183 

Minneapolis, MN 16 

Nashville, TN 99 

New Orleans, LA 153 

New York City, NY 1,077 

Newark, NJ 55 

Norfolk, VA 101 

Oakland, CA 25 

Oklahoma City, OK 89 

Omaha, NE 0 

Philadelphia, PA 839 

Phoenix, AZ 108 

Pittsburgh, PA 3 

Portland, OR 6 

Richmond, VA 78 

Rochester, NY 23 

Sacramento, CA 15 

San Antonio, TX 115 

San Diego, CA 43 

San Francisco, CA 11 

San Jose, CA 6 

Seattle, WA 0 

St Louis, MO 136 

St Paul, MN 2 

St Petersburg, FL 35 

Tampa, FL 139 

Toledo, OH 23 

Tucson, AZ 14 

Tulsa, OK 48 

Washington, DC 371 

Wichita, KS 30 

Yonkers, NY 12 

0 

6 

367 

33 

975 

225 

62 

5 

86 

918 

26 

164 

34 

6 

306 

28 

7 

19 

254 

34 

192 

0 

528 

33 

81 

10 

6 

649 

66 

591 

427 

140 

14 

173 

119 

670 

30 

87 

33 

50 

2 

648 

189 

2 

8 

58 

9 

10 

96 

17 

16 

4 

5 

83 

1 

28 

83 

6 

6 

16 

348 

45 

5 

4 

5 

303 

19 

646 

95 

60 

2 

97 

563 

11 

98 

42 

13 

405 

5 

7 

11 

180 

14 

121 

0 

367 

44 

69 

2 

6 

525 

64 

382 

242 

94 

5 

148 

84 

645 

56 

50 

25 

70 

3 

407 

193 

1 

5 

36 

9 

12 

63 

21 

15 

5 

8 

63 

1 

19 

76 

5 

6 

44 

288 

13 

2 

6 

2 

241 

23 

472 

103 

41 

1 

99 

522 

5 

63 

34 

9 

384 

5 

4 

2 

223 

9 

66 

1 

248 

102 

37 

1 

16 

330 

38 

338 

294 

84 

7 

201 

65 

659 

23 

34 

22 

147 

2 

394 

266 

1 

5 

34 

2 

3 

72 

23 

14 

11 

6 

40 

1 

15 

51 

5 

14 

40 

284 

11 

2 

1 

19 

173 

27 

384 

62 

29 

1 

63 

297 

2 

29 

32 

3 

361 

2 

1 

6 

328 

11 

80 

1 

134 

125 

46 

1 

4 

187 

40 

325 

329 

55 

11 

173 

32 

447 

58 

23 

4 

86 

1 

261 

220 

1 

12 

18 

0 

2 

102 

10 

18 

4 

16 

21 

1 

23 

56 

3 

14 

8 

238 

1 

0 

U.S. CITY TOTAL 10,449 9,139 6,874 6,257 5,022 

San Juan, PR 308 305 300 296 250 

TOTAL 10,757 9,444 7,174 6,553 5,272 

Rates per 100,000 Population 

1996 1997 1998 1999 2000 

0.8 

0.0 

53.6 

7.2 

133.4 

51.6 

14.9 

1.9 

24.2 

25.5 

5.0 

14.5 

3.2 

3.2 

16.8 

16.4 

1.4 

6.5 

24.8 

6.4 

16.6 

0.0 

22.6 

6.9 

14.3 

7.8 

2.9 

8.4 

10.6 

63.4 

21.4 

19.9 

4.2 

18.6 

32.3 

14.7 

19.3 

43.4 

2.0 

20.3 

0.0 

56.9 

4.1 

0.2 

1.2 

40.8 

9.5 

1.3 

8.8 

1.6 

1.5 

0.4 

0.0 

38.9 

0.7 

4.0 

15.5 

5.1 

1.8 

12.6 

68.8 

6.9 

6.3 

0.0 0.7 1.1 0.2 

1.1 1.0 0.4 3.6 

50.8 41.0 32.4 23.2 

4.8 2.7 3.2 3.7 

148.3 100.1 74.6 60.7 

34.2 14.4 15.7 9.4 

11.1 10.8 7.4 5.2 

1.6 0.6 0.3 0.3 

14.0 15.4 15.3 9.7 

31.5 18.9 17.5 10.0 

3.1 1.3 0.6 0.2 

11.8 7.1 4.6 2.1 

3.3 4.1 3.3 3.1 

1.9 4.1 2.9 1.0 

15.1 19.7 18.6 17.5 

5.0 0.9 0.9 0.4 

1.4 1.4 0.8 0.2 

5.4 3.1 0.5 1.6 

23.3 14.3 17.8 26.2 

4.8 2.0 1.3 1.6 

14.5 8.9 4.8 5.8 

0.0 0.0 0.1 0.1 

16.7 11.4 7.6 4.1 

4.1 5.4 12.6 15.4 

11.1 9.4 5.0 6.2 

4.6 0.9 0.5 0.5 

1.3 1.3 3.5 0.9 

7.6 6.1 3.8 2.1 

9.8 9.5 5.6 5.9 

68.2 44.0 38.7 37.2 

20.9 11.2 13.5 15.1 

15.4 10.3 9.3 6.1 

3.7 1.4 1.9 3.0 

32.4 27.7 37.9 32.6 

25.4 18.0 14.1 6.9 

9.1 8.7 8.9 6.0 

10.5 19.7 8.1 20.5 

37.9 23.2 15.1 10.2 

2.6 2.0 1.7 0.3 

11.3 17.2 35.9 21.0 

0.5 0.7 0.4 0.2 

44.6 28.3 27.8 18.4 

7.0 6.9 9.3 7.7 

0.2 0.1 0.1 0.1 

1.6 1.0 1.0 2.4 

30.1 18.5 17.9 9.5 

3.7 3.7 0.8 0.0 

0.9 1.0 0.3 0.2 

7.2 4.7 5.2 7.4 

0.6 0.8 0.8 0.4 

2.2 2.0 1.9 2.4 

0.2 0.3 0.7 0.2 

0.3 0.5 0.4 1.0 

24.3 18.6 12.0 6.3 

0.4 0.4 0.4 0.4 

3.2 2.2 1.7 2.6 

9.1 8.2 5.4 6.0 

1.3 1.1 1.1 0.7 

0.8 0.8 1.7 1.7 

4.1 11.6 10.4 2.1 

65.8 55.1 54.7 45.9 

10.3 2.9 2.4 0.2 

2.6 1.0 1.0 0.0 

15.1 13.1 9.7 8.8 7.1 

35.3 35.0 28.7 28.1 23.8 

15.3 13.4 10.0 9.1 7.3 

STD Surveillance 2000 Syphilis Tables 117 
Table 35. Late and late latent syphilis — Reported cases and rates by state/area listed in alphabetical order: 

United States and outlying areas, 1996–2000 

Cases Rates per 100,000 Population 

State/Area 1996 1997 1998 1999 2000 1996 1997 1998 1999 2000 

Alabama 538 422 413 443 403 12.5 9.8 9.5 10.1 9.2 

Alaska 15 11 12 11 5 2.5 1.8 2.0 1.8 0.8 

Arizona 231 255 281 307 385 5.2 5.6 6.0 6.4 8.1 

Arkansas 103 121 183 140 130 4.1 4.8 7.2 5.5 5.1 

California 2,567 2,319 1,637 1,897 2,590 8.1 7.2 5.0 5.7 7.8 

Colorado 115 125 100 76 45 3.0 3.2 2.5 1.9 1.1 

Connecticut 125 175 114 97 125 3.8 5.4 3.5 3.0 3.8 

Delaware 49 52 49 46 26 6.8 7.1 6.6 6.1 3.5 

Florida 1,128 1,198 1,082 1,231 1,150 7.8 8.2 7.3 8.1 7.6 

Georgia 931 1,218 749 799 695 12.7 16.3 9.8 10.3 8.9 

Hawaii 25 46 14 7 17 2.1 3.9 1.2 0.6 1.4 

Idaho 14 18 13 11 10 1.2 1.5 1.1 0.9 0.8 

Illinois 549 414 892 852 797 4.6 3.5 7.4 7.0 6.6 

Indiana 197 199 173 173 212 3.4 3.4 2.9 2.9 3.6 

Iowa 25 38 23 24 36 0.9 1.3 0.8 0.8 1.3 

Kansas 62 77 63 62 50 2.4 3.0 2.4 2.3 1.9 

Kentucky 113 141 127 120 103 2.9 3.6 3.2 3.0 2.6 

Louisiana 902 872 767 701 526 20.8 20.0 17.6 16.0 12.0 

Maine 1 9 3 1 6 0.1 0.7 0.2 0.1 0.5 

Maryland 317 288 616 405 338 6.3 5.7 12.0 7.8 6.5 

Massachusetts 364 524 416 283 296 6.0 8.6 6.8 4.6 4.8 

Michigan 233 258 202 207 232 2.4 2.6 2.1 2.1 2.4 

Minnesota 69 87 58 52 43 1.5 1.9 1.2 1.1 0.9 

Mississippi 10 48 235 147 125 0.4 1.8 8.5 5.3 4.5 

Missouri 123 173 90 191 215 2.3 3.2 1.7 3.5 3.9 

Montana 0 1 0 0 0 0.0 0.1 0.0 0.0 0.0 

Nebraska 16 26 24 12 4 1.0 1.6 1.4 0.7 0.2 

Nevada 89 85 86 59 38 5.6 5.1 4.9 3.3 2.1 

New Hampshire 25 26 11 14 17 2.2 2.2 0.9 1.2 1.4 

New Jersey 888 696 411 587 599 11.1 8.6 5.1 7.2 7.4 

New Mexico 70 86 54 66 57 4.1 5.0 3.1 3.8 3.3 

New York 4,957 4,639 4,291 3,201 2,308 27.3 25.6 23.6 17.6 12.7 

North Carolina 516 584 540 490 375 7.1 7.9 7.2 6.4 4.9 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 217 202 109 98 89 1.9 1.8 1.0 0.9 0.8 

Oklahoma 62 105 97 94 82 1.9 3.2 2.9 2.8 2.4 

Oregon 52 23 19 23 18 1.6 0.7 0.6 0.7 0.5 

Pennsylvania 335 354 367 427 321 2.8 2.9 3.1 3.6 2.7 

Rhode Island 60 75 54 51 33 6.1 7.6 5.5 5.1 3.3 

South Carolina 259 261 198 230 206 7.0 6.9 5.2 5.9 5.3 

South Dakota 2 5 1 1 1 0.3 0.7 0.1 0.1 0.1 

Tennessee 480 605 515 439 525 9.0 11.3 9.5 8.0 9.6 

Texas 2,674 2,694 1,930 1,885 1,659 14.0 13.9 9.8 9.4 8.3 

Utah 38 49 50 42 46 1.9 2.4 2.4 2.0 2.2 

Vermont 0 1 0 0 0 0.0 0.2 0.0 0.0 0.0 

Virginia 450 495 334 354 266 6.8 7.4 4.9 5.2 3.9 

Washington 119 107 82 110 85 2.2 1.9 1.4 1.9 1.5 

West Virginia 44 17 6 7 7 2.4 0.9 0.3 0.4 0.4 

Wisconsin 74 50 58 52 60 1.4 1.0 1.1 1.0 1.1 

Wyoming 6 4 1 0 4 1.2 0.8 0.2 0.0 0.8 

U.S. TOTAL1 20,364 20,446 17,752 16,654 15,597 7.7 7.6 6.6 6.1 5.7 

Guam 3 1 3 10 7 2.0 0.6 1.9 6.1 4.3 

Puerto Rico 620 640 597 614 485 16.7 16.7 15.5 15.8 12.5 

Virgin Islands 0 0 0 0 3 0.0 0.0 0.0 0.0 2.7 

OUTLYING AREAS 623 641 600 624 495 15.6 15.7 14.5 15.0 11.9 

TOTAL 20,987 21,087 18,352 17,278 16,092 7.8 7.8 6.7 6.2 5.8 

1

Includes cases reported by Washington, D.C. 

118 Syphilis Tables STD Surveillance 2000 
Table 36. Late and late latent syphilis — Reported cases and rates in selected cities of >200,000 population 

listed in alphabetical order: United States and outlying areas, 1996–2000 

Cases 

City 

Akron, OH 

Albuquerque, NM 

Atlanta, GA 

Austin, TX 

Baltimore, MD 

Birmingham, AL 

Boston, MA 

Buffalo, NY 

Charlotte, NC 

Chicago, IL 

Cincinnati, OH 

Cleveland, OH 

Columbus, OH 

Corpus Christi, TX 

Dallas, TX 

Dayton, OH 

Denver, CO 

Des Moines, IA 

Detroit, MI 

El Paso, TX 

Fort Worth, TX 

Honolulu, HI 

Houston, TX 

Indianapolis, IN 

Jacksonville, FL 

Jersey City, NJ 

Kansas City, MO 

Los Angeles, CA 

Louisville, KY 

Memphis, TN 

Miami, FL 

Milwaukee, WI 

Minneapolis, MN 

Nashville, TN 

New Orleans, LA 

New York City, NY 

Newark, NJ 

Norfolk, VA 

Oakland, CA 

Oklahoma City, OK 

Omaha, NE 

Philadelphia, PA 

Phoenix, AZ 

Pittsburgh, PA 

Portland, OR 

Richmond, VA 

Rochester, NY 

Sacramento, CA 

San Antonio, TX 

San Diego, CA 

San Francisco, CA 

San Jose, CA 

Seattle, WA 

St Louis, MO 

St Paul, MN 

St Petersburg, FL 

Tampa, FL 

Toledo, OH 

Tucson, AZ 

Tulsa, OK 

Washington, DC 

Wichita, KS 

Yonkers, NY 

1996 

4 

31 

190 

30 

73 

149 

130 

8 

31 

100 

46 

40 

3 

19 

217 

66 

48 

5 

144 

60 

63 

23 

1,095 

45 

48 

68 

18 

1,165 

49 

399 

364 

53 

31 

0 

198 

4,455 

256 

24 

96 

20 

5 

255 

143 

11 

32 

27 

31 

34 

231 

143 

105 

59 

60 

43 

12 

42 

115 

10 

35 

18 

125 

13 

21 

1997 

0 

41 

289 

57 

81 

136 

191 

13 

19 

0 

33 

19 

28 

14 

260 

70 

57 

7 

175 

73 

62 

41 

1,128 

21 

89 

62 

4 

806 

56 

473 

367 

42 

27 

36 

208 

4,110 

159 

26 

86 

16 

14 

300 

156 

14 

11 

29 

21 

36 

182 

206 

101 

83 

46 

109 

7 

40 

83 

13 

34 

11 

168 

22 

27 

1998 1999 2000 

0 

29 

120 

22 

331 

110 

155 

6 

44 

507 

9 

20 

17 

13 

187 

28 

24 

6 

131 

65 

27 

14 

879 

30 

69 

28 

2 

557 

54 

383 

463 

62 

25 

58 

157 

3,881 

82 

25 

91 

39 

19 

287 

187 

11 

8 

20 

21 

16 

143 

135 

88 

54 

28 

46 

6 

29 

65 

10 

23 

14 

202 

5 

17 

0 

37 

119 

20 

202 

149 

107 

4 

39 

476 

6 

11 

30 

10 

156 

9 

37 

5 

136 

60 

87 

4 

755 

38 

30 

38 

41 

740 

69 

321 

409 

36 

15 

54 

108 

2,907 

115 

30 

92 

34 

3 

355 

245 

4 

9 

17 

13 

13 

121 

196 

84 

40 

51 

69 

3 

18 

41 

10 

20 

23 

129 

16 

9 

1 

33 

88 

24 

111 

124 

106 

8 

40 

473 

12 

7 

18 

6 

120 

10 

18 

11 

145 

73 

85 

13 

614 

92 

53 

22 

39 

1,496 

51 

297 

356 

49 

14 

145 

70 

2,115 

170 

22 

75 

25 

3 

281 

324 

3 

7 

17 

6 

20 

113 

195 

91 

36 

50 

82 

6 

34 

55 

13 

14 

16 

237 

7 

9 

U.S. CITY TOTAL 11,434 11,095 10,184 9,025 8,850 

San Juan, PR 339 312 293 322 222 

TOTAL 11,773 11,407 10,477 9,347 9,072 

Rates per 100,000 Population 

1996 1997 1998 1999 2000 

0.8 

5.9 

26.6 

4.4 

10.9 

22.5 

23.3 

2.5 

5.2 

3.4 

5.4 

2.9 

0.3 

6.0 

10.9 

11.7 

9.7 

1.4 

13.2 

8.8 

4.8 

2.6 

35.2 

5.5 

6.6 

31.3 

4.0 

13.7 

7.3 

46.1 

17.9 

5.8 

8.1 

0.0 

41.8 

60.7 

89.6 

10.3 

7.8 

4.6 

1.1 

17.3 

5.5 

0.9 

6.5 

14.1 

12.8 

3.0 

17.6 

5.3 

14.4 

3.7 

3.7 

12.3 

4.4 

4.8 

12.9 

2.2 

4.6 

4.7 

23.2 

3.0 

10.9 

0.0 0.0 0.0 0.2 

7.8 5.5 7.1 6.3 

40.0 16.2 16.0 11.8 

8.2 3.1 2.8 3.3 

12.3 51.3 31.9 17.5 

20.6 16.7 22.7 18.9 

34.3 27.9 19.2 19.1 

4.1 1.9 1.3 2.5 

3.1 7.0 6.0 6.2 

0.0 17.0 16.0 15.9 

3.9 1.1 0.7 1.4 

1.4 1.4 0.8 0.5 

2.8 1.7 2.9 1.8 

4.4 4.1 3.2 1.9 

12.9 9.1 7.6 5.8 

12.5 5.0 1.6 1.8 

11.4 4.8 7.4 3.6 

2.0 1.7 1.4 3.0 

16.1 10.4 10.9 11.6 

10.4 9.2 8.5 10.4 

4.7 2.0 6.3 6.1 

4.7 1.6 0.5 1.5 

35.7 27.4 23.2 18.9 

2.6 3.7 4.7 11.3 

12.1 9.4 4.1 7.2 

28.5 12.7 17.4 10.1 

0.9 0.4 9.1 8.6 

9.4 6.5 8.5 17.1 

8.4 8.0 10.3 7.6 

54.6 44.1 36.8 34.0 

17.9 21.5 18.8 16.4 

4.6 6.8 4.0 5.4 

7.0 6.9 4.1 3.8 

6.7 10.9 10.2 27.4 

44.3 33.7 23.4 15.2 

56.0 52.3 39.1 28.5 

55.9 28.8 40.6 60.0 

11.3 11.6 13.3 9.7 

6.9 7.1 7.1 5.8 

3.6 9.6 8.3 6.1 

3.2 4.3 0.7 0.7 

20.7 20.0 25.0 19.8 

5.8 6.7 8.6 11.3 

1.1 0.9 0.3 0.2 

2.2 1.6 1.8 1.4 

15.1 10.3 9.0 9.0 

8.7 8.7 5.4 2.5 

3.2 1.4 1.1 1.7 

13.7 10.6 8.8 8.2 

7.6 4.9 6.9 6.9 

13.8 11.8 11.2 12.2 

5.2 3.3 2.4 2.2 

2.8 1.7 3.1 3.0 

31.9 13.6 20.7 24.6 

2.5 2.2 1.1 2.2 

4.6 3.3 2.0 3.9 

9.1 7.0 4.4 5.8 

2.9 2.2 2.2 2.9 

4.4 2.9 2.5 1.7 

2.9 3.7 6.0 4.2 

31.8 38.6 24.9 45.7 

5.0 1.1 3.5 1.5 

14.0 8.8 4.6 4.6 

16.5 15.9 14.4 12.7 12.5 

38.9 35.8 28.0 30.6 21.1 

16.8 16.2 14.6 13.0 12.6 

STD Surveillance 2000 Syphilis Tables 119 
Table 37. Congenital syphilis — Reported cases and rates in infants <1 year of age: United States (excluding 

outlying areas), 1963–2000 

Year* Cases Rate per 100,000 Live Births 

1963 367 9.2 

1964 336 8.7 

1965 335 8.9 

1966 333 8.8 

1967 156 4.1 

1968 274 7.3 

1969 264 7.0 

1970 323 8.6 

1971 422 11.9 

1972 360 11.0 

1973 295 9.4 

1974 250 7.9 

1975 169 5.3 

1976 160 5.1 

1977 134 4.0 

1978 104 3.0 

1979 123 3.5 

1980 107 3.0 

1981 160 4.4 

1982 159 4.3 

1983 158 4.3 

1984 247 6.7 

1985 266 7.1 

1986 357 9.5 

1987 444 11.7 

1988 658 16.8 

1989 1,807 44.7 

1990 3,816 91.8 

1991 4,410 107.3 

1992 4,024 99.0 

1993 3,395 84.9 

1994 2,435 61.6 

1995 1,857 47.6 

1996 1,279 32.9 

1997 1,077 27.8 

1998 839 21.3 

1999 573 14.5 

2000 529 13.4 

*Years 1963-1966 are fiscal years. 

NOTE: The surveillance case definition for congenital syphilis changed in 1988 (see Appendix). As of 1995, cases of congenital syphilis <1 year of 

age are obtained using case reporting form CDC 73.126. Yearly case counts in this table correspond to confirmed diagnoses of congenital syphilis 

among those known to be less than one year of age. As a result, the case counts in this table are a subset of those listed in Table 1 for the years prior 

to 1995. 

120 Syphilis Tables STD Surveillance 2000 
Table 38. Congenital syphilis — Reported cases and rates in infants <1 year of age by state/area, ranked 

by rates: United States and outlying areas, 2000 

Rank State/Area* Cases Rate per 100,000 Live Births 

1 South Carolina 24 44.5 

2 Arkansas 16 43.4 

3 Mississippi 14 32.6 

4 Arizona 25 32.0 

5 Tennessee 24 31.0 

6 Illinois 50 27.4 

7 Puerto Rico 16 26.5 

8 Maryland 16 22.2 

9 Texas 71 20.7 

10 Florida 40 20.4 

11 New Jersey 22 19.2 

12 California 86 16.5 

13 North Carolina 18 16.1 

14 New York 38 14.7 

15 Georgia 17 13.9 

U.S. TOTAL1 529 13.4 

16 Michigan 16 12.0 

17 Alabama 7 11.3 

18 Louisiana 7 10.5 

19 Pennsylvania 9 6.2 

20 Wisconsin 4 5.9 

21 Kentucky 3 5.5 

22 Virginia 5 5.3 

23 Kansas 2 5.2 

24 Missouri 3 4.0 

25 Ohio 5 3.3 

26 Connecticut 1 2.3 

27 Utah 1 2.2 

28 Oklahoma 1 2.0 

YEAR 2010 OBJECTIVE 1.0 

29 Alaska 0 0.0 

30 Colorado 0 0.0 

31 Delaware 0 0.0 

32 Hawaii 0 0.0 

33 Idaho 0 0.0 

34 Indiana 0 0.0 

35 Iowa 0 0.0 

36 Maine 0 0.0 

37 Massachusetts 0 0.0 

38 Minnesota 0 0.0 

39 Montana 0 0.0 

40 Nebraska 0 0.0 

41 Nevada 0 0.0 

42 New Hampshire 0 0.0 

43 New Mexico 0 0.0 

44 North Dakota 0 0.0 

45 Oregon 0 0.0 

46 Rhode Island 0 0.0 

47 South Dakota 0 0.0 

48 Vermont 0 0.0 

49 Washington 0 0.0 

50 West Virginia 0 0.0 

51 Wyoming 0 0.0 

52 Guam 0 0.0 

53 Virgin Islands 0 0.0 

*Mother’s state of residence used to assign case.
 

1

Includes cases reported by Washington, D.C. but excludes outlying areas (Guam, Puerto Rico and Virgin Islands).
 

STD Surveillance 2000 Syphilis Tables 121 
Table 39. Congenital syphilis — Reported cases and rates in infants <1 year of age by state/area listed in 

alphabetical order: United States and outlying areas, 1996–2000 

Cases Rates per 100,000 Live Births 

State/Area* 1996 1997 1998 1999 2000 1996 1997 1998 1999 2000 

Alabama 22 31 12 7 7 36.4 50.9 19.3 11.3 11.3 

Alaska 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Arizona 6 12 25 24 25 8.0 15.9 32.0 30.7 32.0 

Arkansas 32 41 30 14 16 88.0 112.4 81.4 38.0 43.4 

California 196 162 122 88 86 36.3 30.9 23.4 16.9 16.5 

Colorado 3 0 2 1 0 5.4 0.0 3.4 1.7 0.0 

Connecticut 2 2 0 1 1 4.5 4.6 0.0 2.3 2.3 

Delaware 0 2 0 0 0 0.0 19.5 0.0 0.0 0.0 

Florida 93 73 71 31 40 49.1 37.9 36.3 15.8 20.4 

Georgia 29 17 14 15 17 25.4 14.4 11.4 12.3 13.9 

Hawaii 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Idaho 1 0 0 0 0 5.4 0.0 0.0 0.0 0.0 

Illinois 104 74 71 54 50 56.8 40.9 38.9 29.6 27.4 

Indiana 6 3 0 7 0 7.2 3.6 0.0 8.2 0.0 

Iowa 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Kansas 0 2 0 0 2 0.0 5.4 0.0 0.0 5.2 

Kentucky 5 5 5 0 3 9.5 9.4 9.2 0.0 5.5 

Louisiana 15 22 8 12 7 23.0 33.3 12.0 17.9 10.5 

Maine 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Maryland 36 58 44 27 16 50.3 82.6 61.1 37.5 22.2 

Massachusetts 6 1 2 0 0 7.5 1.2 2.5 0.0 0.0 

Michigan 22 29 18 22 16 16.5 21.7 13.5 16.5 12.0 

Minnesota 2 0 0 0 0 3.1 0.0 0.0 0.0 0.0 

Mississippi 54 41 15 12 14 131.7 98.7 34.9 27.9 32.6 

Missouri 15 10 15 10 3 20.3 13.5 19.9 13.3 4.0 

Montana 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Nebraska 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Nevada 1 0 0 0 0 3.8 0.0 0.0 0.0 0.0 

New Hampshire 0 0 0 1 0 0.0 0.0 0.0 6.9 0.0 

New Jersey 80 84 87 49 22 70.0 74.2 75.9 42.8 19.2 

New Mexico 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

New York 155 105 59 43 38 58.7 40.8 22.8 16.7 14.7 

North Carolina 31 18 24 19 18 29.7 16.8 21.5 17.0 16.1 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 15 10 4 6 5 9.9 6.6 2.6 3.9 3.3 

Oklahoma 10 9 16 9 1 21.6 18.6 32.3 18.2 2.0 

Oregon 0 1 0 0 0 0.0 2.3 0.0 0.0 0.0 

Pennsylvania 58 37 21 7 9 39.1 25.7 14.4 4.8 6.2 

Rhode Island 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

South Carolina 44 19 24 23 24 86.1 36.4 44.5 42.7 44.5 

South Dakota 0 0 1 1 0 0.0 0.0 9.7 9.7 0.0 

Tennessee 35 32 13 10 24 47.5 43.0 16.8 12.9 31.0 

Texas 166 149 114 68 71 50.2 44.6 33.3 19.9 20.7 

Utah 0 0 1 0 1 0.0 0.0 2.2 0.0 2.2 

Vermont 1 0 0 0 0 14.8 0.0 0.0 0.0 0.0 

Virginia 16 7 6 3 5 17.3 7.6 6.4 3.2 5.3 

Washington 1 0 1 1 0 1.3 0.0 1.3 1.3 0.0 

West Virginia 0 1 0 0 0 0.0 4.8 0.0 0.0 0.0 

Wisconsin 3 9 6 8 4 4.5 13.5 8.9 11.9 5.9 

Wyoming 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

U.S. TOTAL1 1,279 1,077 839 573 529 32.9 27.8 21.3 14.5 13.4 

Guam 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Puerto Rico 10 9 28 23 16 15.8 14.0 46.3 38.1 26.5 

Virgin Islands 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

OUTLYING AREAS 10 9 28 23 16 14.4 12.8 42.1 34.6 24.0 

TOTAL 1,289 1,086 867 596 545 32.5 27.5 21.6 14.9 13.6 

*Mother’s state of residence used to assign case. 

1

Includes cases reported by Washington, D.C. 

122 Syphilis Tables STD Surveillance 2000 
5

10

15

20

25

30

35

40

45

50

55

60

Table 40. Congenital syphilis — Reported cases and rates in infants <1 year of age in selected cities of 

>200,000 population, ranked by rates: United States and outlying areas, 2000 

Rank City* Cases Rate per 100,000 Live Births 

1 Newark, NJ 8 165.2 

2 Baltimore, MD 15 152.9 

3 Miami, FL 18 135.6 

4 Memphis, TN 13 114.2 

Phoenix, AZ 20 86.3 

6 Atlanta, GA 7 80.1 

7 San Juan, PR 5 76.5 

8 Jersey City, NJ 3 76.4 

9 Chicago, IL 38 73.8 

Houston, TX 31 73.7 

11 Los Angeles, CA 41 62.3 

12 Nashville, TN 5 60.1 

13 Detroit, MI 9 54.8 

14 Washington, DC 4 52.0 

Norfolk, VA 2 49.6 

16 Birmingham, AL 2 45.0 

17 Philadelphia, PA 9 40.7 

18 Fort Worth, TX 4 40.5 

19 Milwaukee, WI 4 36.4 

Charlotte, NC 3 32.3 

21 Kansas City, MO 2 27.8 

22 New York City, NY 32 26.7 

23 Dallas, TX 6 25.8 

24 San Antonio, TX 5 22.9 

Cleveland, OH 2 22.3 

26 Sacramento, CA 2 18.8 

27 St Louis, MO 1 17.8 

28 Jacksonville, FL 2 17.6 

29 Oakland, CA 1 15.7 

El Paso, TX 2 15.2 

31 Louisville, KY 1 14.6 

32 San Francisco, CA 1 12.3 

33 San Jose, CA 1 6.1 

YEAR 2010 OBJECTIVE 1.0 

34 Tucson, AZ 0 0.0 

San Diego, CA 0 0.0 

36 Denver, CO 0 0.0 

37 St Petersburg, FL 0 0.0 

38 Tampa, FL 0 0.0 

39 Honolulu, HI 0 0.0 

Indianapolis, IN 0 0.0 

41 Des Moines, IA 0 0.0 

42 Wichita, KS 0 0.0 

43 New Orleans, LA 0 0.0 

44 Boston, MA 0 0.0 

Minneapolis, MN 0 0.0 

46 St Paul, MN 0 0.0 

47 Omaha, NE 0 0.0 

48 Albuquerque, NM 0 0.0 

49 Buffalo, NY 0 0.0 

Rochester, NY 0 0.0 

51 Yonkers, NY 0 0.0 

52 Akron, OH 0 0.0 

53 Cincinnati, OH 0 0.0 

54 Columbus, OH 0 0.0 

Dayton, OH 0 0.0 

56 Toledo, OH 0 0.0 

57 Oklahoma City, OK 0 0.0 

58 Tulsa, OK 0 0.0 

59 Portland, OR 0 0.0 

Pittsburgh, PA 0 0.0 

61 Austin, TX 0 0.0 

62 Corpus Christi, TX 0 0.0 

63 Richmond, VA 0 0.0 

64 Seattle, WA 0 0.0 

*Mother’s residence used to assign case.
 

STD Surveillance 2000 Syphilis Tables 123
 
Table 41. Congenital syphilis — Reported cases and rates in infants <1 year of age in selected cities of 

>200,000 population listed in alphabetical order: United States and outlying areas, 1996–2000 

Cases 

City* 1996 1997 1998 1999 2000 

Akron, OH 0 0 0 0 0 

Albuquerque, NM 0 0 0 0 0 

Atlanta, GA 15 12 5 7 7 

Austin, TX 0 0 0 0 0 

Baltimore, MD 30 56 29 21 15 

Birmingham, AL 11 6 5 2 2 

Boston, MA 2 0 2 0 0 

Buffalo, NY 2 3 0 0 0 

Charlotte, NC 2 0 1 3 3 

Chicago, IL 66 50 49 44 38 

Cincinnati, OH 1 0 0 0 0 

Cleveland, OH 5 6 3 2 2 

Columbus, OH 0 1 1 2 0 

Corpus Christi, TX 0 0 1 0 0 

Dallas, TX 2 3 18 4 6 

Dayton, OH 7 0 0 0 0 

Denver, CO 1 0 1 1 0 

Des Moines, IA 0 0 0 0 0 

Detroit, MI 15 25 14 21 9 

El Paso, TX 4 2 0 1 2 

Fort Worth, TX 5 6 1 2 4 

Honolulu, HI 0 0 0 0 0 

Houston, TX 98 101 56 31 31 

Indianapolis, IN 0 0 0 6 0 

Jacksonville, FL 1 0 0 0 2 

Jersey City, NJ 1 4 3 0 3 

Kansas City, MO 0 1 0 1 2 

Los Angeles, CA 97 67 62 36 41 

Louisville, KY 3 3 4 0 1 

Memphis, TN 27 28 11 10 13 

Miami, FL 37 31 37 10 18 

Milwaukee, WI 3 9 6 7 4 

Minneapolis, MN 1 0 0 0 0 

Nashville, TN 1 0 0 0 5 

New Orleans, LA 0 4 2 4 0 

New York City, NY 131 84 45 40 32 

Newark, NJ 27 26 26 12 8 

Norfolk, VA 5 1 0 0 2 

Oakland, CA 8 2 2 3 1 

Oklahoma City, OK 4 5 11 5 0 

Omaha, NE 0 0 0 0 0 

Philadelphia, PA 58 37 21 7 9 

Phoenix, AZ 2 10 19 16 20 

Pittsburgh, PA 0 0 0 0 0 

Portland, OR 0 1 0 0 0 

Richmond, VA 0 1 3 0 0 

Rochester, NY 1 0 2 1 0 

Sacramento, CA 3 5 2 2 2 

San Antonio, TX 7 4 5 4 5 

San Diego, CA 5 13 7 7 0 

San Francisco, CA 2 2 1 1 1 

San Jose, CA 2 1 0 2 1 

Seattle, WA 0 0 0 1 0 

St Louis, MO 8 5 3 5 1 

St Paul, MN 0 0 0 0 0 

St Petersburg, FL 1 0 0 1 0 

Tampa, FL 16 7 4 4 0 

Toledo, OH 0 0 0 0 0 

Tucson, AZ 2 0 0 0 0 

Tulsa, OK 3 1 3 1 0 

Washington, DC 14 11 8 0 4 

Wichita, KS 0 2 0 0 0 

Yonkers, NY 0 0 2 0 0 

U.S. CITY TOTAL 736 636 475 327 294 

San Juan, PR 1 3 1 3 5 

TOTAL 737 639 476 330 299 

Rates per 100,000 Live Births 

1996 1997 1998 1999 2000 

0.0 

0.0 

184.7 

0.0 

289.3 

265.3 

25.8 

41.6 

23.7 

124.9 

17.3 

53.8 

0.0 

0.0 

9.0 

246.1 

10.9 

0.0 

90.4 

29.7 

53.3 

0.0 

235.2 

0.0 

9.0 

24.8 

0.0 

137.2 

44.2 

243.1 

246.5 

26.7 

17.2 

12.4 

0.0 

106.5 

530.1 

122.2 

124.7 

54.6 

0.0 

254.4 

8.5 

0.0 

0.0 

0.0 

24.5 

27.7 

32.6 

25.5 

23.9 

12.3 

0.0 

136.7 

0.0 

29.2 

232.2 

0.0 

22.9 

50.5 

166.9 

0.0 

0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

142.7 57.2 80.1 80.1 

0.0 0.0 0.0 0.0 

573.4 295.6 214.0 152.9 

139.2 112.6 45.0 45.0 

0.0 25.4 0.0 0.0 

62.7 0.0 0.0 0.0 

0.0 10.8 32.3 32.3 

97.7 95.2 85.4 73.8 

0.0 0.0 0.0 0.0 

63.2 33.5 22.3 22.3 

9.1 8.9 17.7 0.0 

0.0 21.6 0.0 0.0 

13.3 77.4 17.2 25.8 

0.0 0.0 0.0 0.0 

0.0 10.2 10.2 0.0 

0.0 0.0 0.0 0.0 

149.4 85.2 127.8 54.8 

15.2 0.0 7.6 15.2 

63.2 10.1 20.2 40.5 

0.0 0.0 0.0 0.0 

242.8 133.2 73.7 73.7 

0.0 0.0 44.6 0.0 

0.0 0.0 0.0 17.6 

101.9 76.4 0.0 76.4 

13.1 0.0 13.9 27.8 

98.6 94.2 54.7 62.3 

46.0 58.5 0.0 14.6 

248.5 96.6 87.8 114.2 

218.4 278.7 75.3 135.6 

83.8 54.5 63.6 36.4 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 60.1 

51.7 26.4 52.8 0.0 

70.6 37.5 33.4 26.7 

509.4 536.7 247.7 165.2 

25.5 0.0 0.0 49.6 

31.2 31.4 47.0 15.7 

65.6 142.8 64.9 0.0 

0.0 0.0 0.0 0.0 

167.6 95.0 31.7 40.7 

44.2 82.0 69.1 86.3 

0.0 0.0 0.0 0.0 

14.0 0.0 0.0 0.0 

30.5 105.2 0.0 0.0 

0.0 46.3 23.1 0.0 

47.6 18.8 18.8 18.8 

18.6 22.9 18.4 22.9 

69.6 37.8 37.8 0.0 

24.4 12.3 12.3 12.3 

6.2 0.0 12.3 6.1 

0.0 0.0 13.7 0.0 

86.7 53.4 89.0 17.8 

0.0 0.0 0.0 0.0 

0.0 0.0 28.8 0.0 

100.6 50.8 50.8 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

15.7 45.1 15.0 0.0 

138.8 104.1 0.0 52.0 

32.2 0.0 0.0 0.0 

0.0 74.3 0.0 0.0 

91.7 80.3 59.4 40.9 36.8 

14.3 43.2 15.3 45.9 76.5 

91.1 80.0 59.1 40.9 37.1 

*Mother’s residence used to assign case. 

NOTE: As of 1995, cases of congenital syphilis <1 year of age are obtained using case reporting form CDC 73.126. 

124 Syphilis Tables STD Surveillance 2000 
Table 42. Chancroid — Reported cases and rates by state/area listed in alphabetical order: United States and 

outlying areas, 1996–2000 

Cases Rates per 100,000 Population 

State/Area 1996 1997 1998 1999 2000 1996 1997 1998 1999 2000 

Alabama 0 1 1 1 1 0.0 0.0 0.0 0.0 0.0 

Alaska 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Arizona 2 0 2 0 0 0.0 0.0 0.0 0.0 0.0 

Arkansas 1 1 7 0 0 0.0 0.0 0.3 0.0 0.0 

California 8 19 7 7 3 0.0 0.1 0.0 0.0 0.0 

Colorado 0 0 0 0 1 0.0 0.0 0.0 0.0 0.0 

Connecticut 0 0 2 0 0 0.0 0.0 0.1 0.0 0.0 

Delaware 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Florida 3 3 3 2 0 0.0 0.0 0.0 0.0 0.0 

Georgia 0 1 2 1 0 0.0 0.0 0.0 0.0 0.0 

Hawaii 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Idaho 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Illinois 20 5 0 0 0 0.2 0.0 0.0 0.0 0.0 

Indiana 1 0 1 0 0 0.0 0.0 0.0 0.0 0.0 

Iowa 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Kansas 2 0 1 0 0 0.1 0.0 0.0 0.0 0.0 

Kentucky 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Louisiana 58 3 1 9 6 1.3 0.1 0.0 0.2 0.1 

Maine 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Maryland 2 1 0 0 0 0.0 0.0 0.0 0.0 0.0 

Massachusetts 2 4 0 1 2 0.0 0.1 0.0 0.0 0.0 

Michigan 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Minnesota 0 0 0 1 0 0.0 0.0 0.0 0.0 0.0 

Mississippi 1 1 3 0 0 0.0 0.0 0.1 0.0 0.0 

Missouri 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Montana 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Nebraska 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Nevada 0 2 0 0 0 0.0 0.1 0.0 0.0 0.0 

New Hampshire 1 0 0 0 0 0.1 0.0 0.0 0.0 0.0 

New Jersey 4 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

New Mexico 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

New York 182 119 82 39 26 1.0 0.7 0.5 0.2 0.1 

North Carolina 14 9 9 7 5 0.2 0.1 0.1 0.1 0.1 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 6 3 3 0 1 0.1 0.0 0.0 0.0 0.0 

Oklahoma 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Oregon 0 1 0 1 0 0.0 0.0 0.0 0.0 0.0 

Pennsylvania 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Rhode Island 0 0 0 1 0 0.0 0.0 0.0 0.1 0.0 

South Carolina 8 15 19 48 10 0.2 0.4 0.5 1.2 0.3 

South Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Tennessee 2 1 0 0 0 0.0 0.0 0.0 0.0 0.0 

Texas 65 53 34 16 19 0.3 0.3 0.2 0.1 0.1 

Utah 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Vermont 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Virginia 1 1 7 3 2 0.0 0.0 0.1 0.0 0.0 

Washington 1 2 1 0 0 0.0 0.0 0.0 0.0 0.0 

West Virginia 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Wisconsin 2 0 3 4 2 0.0 0.0 0.1 0.1 0.0 

Wyoming 0 1 1 1 0 0.0 0.2 0.2 0.2 0.0 

U.S. TOTAL1 386 246 189 142 78 0.1 0.1 0.1 0.1 0.0 

Guam 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Puerto Rico 2 1 2 1 3 0.1 0.0 0.1 0.0 0.1 

Virgin Islands 0 0 0 0 1 0.0 0.0 0.0 0.0 0.9 

OUTLYING AREAS 2 1 2 1 4 0.1 0.0 0.0 0.0 0.1 

TOTAL 388 247 191 143 82 0.1 0.1 0.1 0.1 0.0 

1

Includes cases reported by Washington, D.C. 

STD Surveillance 2000 Chancroid Tables 125 
Table 43. Chancroid — Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1996–2000 

Cases 

City 1996 1997 1998 1999 2000 

Akron, OH 0 0 0 0 0 

Albuquerque, NM 0 0 0 0 0 

Atlanta, GA 0 1 1 0 0 

Austin, TX 0 0 0 0 0 

Baltimore, MD 1 0 0 0 0 

Birmingham, AL 0 0 0 0 0 

Boston, MA 0 3 0 0 0 

Buffalo, NY 0 0 0 0 0 

Charlotte, NC 4 1 0 1 0 

Chicago, IL 20 5 0 0 0 

Cincinnati, OH 0 0 0 0 0 

Cleveland, OH 0 0 2 0 0 

Columbus, OH 0 3 1 0 0 

Corpus Christi, TX 0 0 0 1 0 

Dallas, TX 13 13 6 4 6 

Dayton, OH 1 0 0 0 0 

Denver, CO 0 0 0 0 0 

Des Moines, IA 0 0 0 0 0 

Detroit, MI 0 0 0 0 0 

El Paso, TX 1 2 4 0 1 

Fort Worth, TX 0 1 0 2 2 

Honolulu, HI 0 0 0 0 0 

Houston, TX 25 23 20 7 3 

Indianapolis, IN 0 0 0 0 0 

Jacksonville, FL 0 0 0 0 0 

Jersey City, NJ 0 0 0 0 0 

Kansas City, MO 0 0 0 0 0 

Los Angeles, CA 2 12 0 1 1 

Louisville, KY 0 0 0 0 0 

Memphis, TN 2 0 0 0 0 

Miami, FL 0 0 0 0 0 

Milwaukee, WI 1 0 2 2 0 

Minneapolis, MN 0 0 0 1 0 

Nashville, TN 0 0 0 0 0 

New Orleans, LA 52 3 0 4 6 

New York City, NY 181 119 82 39 26 

Newark, NJ 0 0 0 0 0 

Norfolk, VA 0 0 0 1 0 

Oakland, CA 0 1 0 1 0 

Oklahoma City, OK 0 0 0 0 0 

Omaha, NE 0 0 0 0 0 

Philadelphia, PA 0 0 0 0 0 

Phoenix, AZ 1 0 2 0 0 

Pittsburgh, PA 0 0 0 0 0 

Portland, OR 0 0 0 0 0 

Richmond, VA 0 0 0 0 0 

Rochester, NY 0 0 0 0 0 

Sacramento, CA 0 0 0 0 0 

San Antonio, TX 0 0 0 0 1 

San Diego, CA 2 0 0 0 0 

San Francisco, CA 1 3 4 0 0 

San Jose, CA 0 0 0 0 0 

Seattle, WA 0 1 0 0 0 

St Louis, MO 0 0 0 0 0 

St Paul, MN 0 0 0 0 0 

St Petersburg, FL 0 0 0 0 0 

Tampa, FL 0 0 0 0 0 

Toledo, OH 0 0 0 0 0 

Tucson, AZ 1 0 0 0 0 

Tulsa, OK 0 0 0 0 0 

Washington, DC 0 0 0 0 0 

Wichita, KS 1 0 0 0 0 

Yonkers, NY 0 0 0 0 0 

U.S. CITY TOTAL 309 191 124 64 46 

San Juan, PR 1 0 1 1 2 

TOTAL 310 191 125 65 48 

Rates per 100,000 Population 

1996 1997 1998 1999 2000 

0.0 

0.0 

0.0 

0.0 

0.1 

0.0 

0.0 

0.0 

0.7 

0.7 

0.0 

0.0 

0.0 

0.0 

0.7 

0.2 

0.0 

0.0 

0.0 

0.1 

0.0 

0.0 

0.8 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.2 

0.0 

0.1 

0.0 

0.0 

11.0 

2.5 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.1 

0.1 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.1 

0.0 

0.0 

0.2 

0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.1 0.1 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.5 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.2 0.0 0.2 0.0 

0.2 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.1 0.0 0.0 

0.3 0.1 0.0 0.0 

0.0 0.0 0.3 0.0 

0.6 0.3 0.2 0.3 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.3 0.6 0.0 0.1 

0.1 0.0 0.1 0.1 

0.0 0.0 0.0 0.0 

0.7 0.6 0.2 0.1 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.1 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.2 0.2 0.0 

0.0 0.0 0.3 0.0 

0.0 0.0 0.0 0.0 

0.6 0.0 0.9 1.3 

1.6 1.1 0.5 0.4 

0.0 0.0 0.0 0.0 

0.0 0.0 0.4 0.0 

0.1 0.0 0.1 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.1 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.1 

0.0 0.0 0.0 0.0 

0.4 0.5 0.0 0.0 

0.0 0.0 0.0 0.0 

0.1 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.4 0.3 0.2 0.1 0.1 

0.1 0.0 0.1 0.1 0.2 

0.4 0.3 0.2 0.1 0.1 

126 Chancroid Tables STD Surveillance 2000 
Sources and Limitations of Data
 

CDC Surveillance Data 

Much of the information in this document is based on cases of sexually transmitted diseases (STDs) 

reported to the Division of STD Prevention (DSTD), National Center for HIV, STD, and TB Prevention 

(NCHSTP), Centers for Disease Control and Prevention (CDC), by the STD control programs and 

health departments in the 50 states, the District of Columbia, selected cities, counties, U.S. dependencies and possessions, and independent nations in free association with the United States. Included 

among the dependencies, possessions, and independent nations are Guam, Puerto Rico, and the Virgin 

Islands. These entities are identified as “outlying areas” of the United States in selected tables and 

figures. 

At present, STD data are submitted to CDC on a variety of hardcopy summary reporting forms 

(monthly, quarterly, and annually) and electronically either in summary or individual case-listed format 

via the National Electronic Telecommunications System for Surveillance (NETSS), that provides notifiable disease information that is published in the Morbidity and Mortality Weekly Report (MMWR). 

DSTD is currently working with project areas on converting from hardcopy reporting of summary data 

to electronic submission of line-listed (i.e., case-specific) data through NETSS. As of December 31, 

2000, 36 states have been reporting primary and secondary (P&S) syphilis, chlamydia and gonorrhea 

as line-listed extended electronic data. See Figures A1-A3 in this Appendix for type of electronic reporting by state and disease. “Summary” refers to aggregate electronic data. “Case” refers to limited 

case-specific electronic data in conjunction with hardcopy reporting. “Extended case” refers to expanded case-specific electronic data in conjunction with hardcopy reporting. “Discontinued hardcopy” 

refers to those states that consistently submitted high quality case-extended electronic data and were, 

therefore, notified by CDC to discontinue hardcopy reporting. 

The data used in this report are based on a combination of aggregated NETSS electronic data and 

summary hardcopy reporting forms. Monthly hardcopy reporting forms included summary data for 

syphilis by county and state. Quarterly hardcopy reporting forms included summary data for syphilis, 

gonorrhea, chlamydia, and other STDs by gender and source of report (STD clinic or non-STD clinic) 

for the 50 states, 64 large cities (most with a population of 200,000 or more persons in 1980), and outlying areas of the United States. Annual hardcopy reporting forms included summary data for P&S syphilis, gonorrhea, and chlamydia by age, race, and gender for the 50 states and six large cities. Provisional 

data on syphilis, gonorrhea, and chlamydia reported to CDC weekly by states for inclusion in the Morbidity and Mortality Weekly Report were not included in this document. 

Areas differ in their ability to resolve differences in total cases derived from hardcopy monthly, quarterly, and annual reports (as well as electronically submitted case-listed data). Thus, depending on the 

database used, there may be discrepancies in the total number of cases among the tables and figures. In 

most instances, these discrepancies are less than 5% of total reported cases and have minimal impact on 

national case totals and rates. However, for a specific area, the discrepancies may be larger. 

Reports and corrections sent to CDC on hardcopy forms and for NETSS electronic data through 

May 4, 2001 have been included in this report. Data received after this date will appear in subsequent 

issues. The data in the tables and figures in this document supersede those in all earlier publications. 

STD Surveillance 2000 Appendix Sources and Limitations of Data 127 
Population Denominators and Rate Calculations 

Crude incidence rates (new cases/population) were calculated on an annual basis per 100,000 persons. In this report, the 2000 rates for all states, cities and outlying areas were calculated by dividing 

the number of cases reported from each area in 2000 by the estimated area-specific 1999 population. 

For the United States, rates were calculated using Bureau of the Census population estimates for 1981 

through 1989 (Bureau of the Census; United States Population Estimates by Age, Sex and Race: 

1980-1989 [Series P-25, No. 1045]; Washington: US Government Printing Office, 1990; and United 

States Population Estimates by Age, Sex and Race: 1989 [Series P-25, No. 1057]; Washington: US 

Government Printing Office, 1990). Rates for states and counties were calculated using published 

intercensal estimates based on Bureau of the Census population estimates for 1980-1989 (Irwin R; 

1980-1989 Intercensal Population Estimates by Race, Sex, and Age; Alexandria, [VA]: Demo-Detail, 

1992; machine-readable data file). Rates for 1990 were calculated using population data from the 

1990 census (Census of Population and Housing, 1990: Summary Tape File 1 (All States) [machine-readable file]; Washington: Bureau of the Census, 1991), which included information on area 

(County, State), age (5-year age groups), race (White, Black, Asian/Pacific Islander, American Indian/Alaska Native) and ethnicity (Hispanic). Rates for 1991-2000 were updated from previous issues 

of this report using postcensal population estimates based on the Bureau of the Census data (U.S. Bureau of the Census; 1991-1999 Estimates of the Population of Counties by Age, Sex and Race/Hispanic Origin: 1990 to 1999; machine-readable data files). 

The total number of U.S. counties in this report, 3,139, differs from earlier versions of this report 

which used 3,115 as the total number of U.S. counties. Individual county-level line-listed NETSS electronic data are now available for Alaska. Previously, Alaska syphilis data were collected on the 

hardcopy reporting forms for only three regions within the state (Southeast, South Central and 

North). 

Many cities do not have a separate health jurisdiction that collects and reports cases of STDs. For 

these cities, case numbers and crude incidence rates are equal to those of the county or counties in 

which the city is located. For the remaining cities, incidence rates were calculated by using population 

estimates based on the Bureau of the Census (Irwin R, see above) and a marketing survey (Market 

Statistics, Inc; Sales and Marketing Management; New York: Bill Communications, Inc, August 1989). 

Population estimates for 1980-1988 for areas outside the United States were obtained from the Bureau of the Census (Bureau of the Census; population estimates for Puerto Rico and the outlying areas: 1980 to 1988; Current Population Reports [Series P-25, No. 1049]; Washington: US 

Government Printing Office, 1989). After 1988, population estimates for outlying areas were obtained from the health departments located in these areas. Population estimates for the Virgin Islands 

were updated through 1997 and were used to calculate the rates for 1997 through 2000. Population 

estimates for Guam were projected for each year through 2000 based on the 1990 census. Puerto 

Rico’s population estimates from 1997 to 1999 were obtained from the Bureau of the Census. 

The percentage of reported cases for which race/ethnicity and age information were missing differed substantially by year and area. States were excluded from comparison across race/ethnicity categories if race/ethnicity data were missing from 50% or more of the state’s reported cases. Similarly, 

states in which age information was missing from the majority of reported cases were excluded from 

comparison across age categories. Missing values for race/ethnicity and age were imputed for records 

missing these data for states in which more than half of the reported cases contained race/ethnicity 

and age information. In previous years, missing age and race/ethnicity information was not imputed if 

128 Sources and Limitations of Data Appendix STD Surveillance 2000 
a record was missing either of these pieces of information. Beginning in 2000, we altered the imputation method so that missing data were not imputed only for records missing both age and sex information. As a result, some age- and/or race/ethnicity-specific case counts and rates presented in this report 

may differ from earlier publications. Values cited in this report supercede those presented earlier. 

Rates of congenital syphilis for 1989-2000 were calculated using live births from the National Center for Health Statistics (NCHS) (Vital Statistics: Natality Tapes 1989-1998 or Vital Statistics Reports, 

United States 1999, Vol. 48 No.10-Natality). Race-specific rates for 1996-2000 were calculated using 

live births for 1998. Rates before 1989 were calculated using published live birth data (NCHS; Vital 

Statistics Report, United States, 1988 [Vol.1—Natality]). 

Case Definitions and Reporting Practices 

Although most areas generally adhere to the case definitions for STDs found in Case Definitions for 

Infectious Conditions Under Public Health Surveillance (MMWR 1997;46(RR-10):1-56), there are 

differences between individual areas in case definitions as well as in the policies and systems for collecting surveillance data. Thus, comparisons of case numbers and rates between areas should be interpreted with caution. However, since case definitions and surveillance activities within a given area 

remain relatively stable, trends should be minimally affected. In many areas, the reporting from publicly supported institutions (e.g., STD clinics) was more complete than from other sources (e.g., private 

practitioners). Thus, the trends may not be representative of all segments of the population. Military 

cases are not reported as a separate category. 

Reporting of Chlamydia Cases 

New York City has been reporting chlamydia cases since 1984. However, the State of New York, 

with the exception of New York City, initiated chlamydia reporting during the year 2000. As a result, 

the number of chlamydia cases reported by the state of New York (including the cities of Buffalo, 

Rochester and Yonkers) may be incomplete and the rate for New York State is underestimated. To 

be consistent with the practice used in earlier years, we included the incomplete New York State 

chlamydia reporting data in the calculation of overall national chlamydia rates. The number of 

chlamydia cases occurring in the fourth quarter of 2000 for the State of Colorado was projected 

based on case counts from the first three quarters. 

Trends in many areas were more reflective of changes in reporting of cases rather than actual 

trends in disease. Cases and rates of chlamydia reported in gender-specific tables are underestimated due to some reported cases with unknown gender. Despite problems with under-reporting, it 

is important to publish available data to emphasize the large numbers of cases of chlamydia being 

detected in the United States. As areas develop chlamydia prevention and control programs, including improved surveillance systems to monitor trends, the data should improve and become 

more representative of true trends in disease. 

Reporting of Gonorrhea Cases 

In 1994, Georgia reported gonorrhea cases to CDC for only part of a year. Therefore, Georgia 

cases and population were excluded from gonorrhea figures and tables for 1994. The city of Atlanta 

was also excluded from city gonorrhea figures and tables for 1994. 

STD Surveillance 2000 Appendix Sources and Limitations of Data 129 
Reporting of Syphilis Cases 

“Total syphilis” or “all stages of syphilis” includes primary, secondary, early latent, late (including 

neurosyphilis, late latent, late with clinical manifestations, and unknown latent), and congenital 

syphilis. Cases of unknown duration, neurosyphilis, and late syphilis with clinical manifestations 

have been counted as late and late latent syphilis. 

Reporting of Congenital Syphilis Cases 

In 1988, a new surveillance case definition for congenital syphilis was introduced. The new case 

definition has greater sensitivity than the former definition.1 In addition, many areas greatly enhanced 

active case finding for congenital syphilis during this time. For these reasons, the number of reported 

cases increased dramatically during 1989-1991. As is true of any change, a period of transition during 

which trends cannot be clearly interpreted has resulted; however, all reporting areas had implemented 

the new case definition for reporting all cases of congenital syphilis by January 1, 1992. Therefore, the 

reliability of trends is expected to have stabilized after this date. 

In addition to changing the case definition, CDC introduced a new data collection form (CDC 

73.126) in 1990. Beginning with 1995, the data collected on this form are used for reporting congenital syphilis reported cases and associated rates. This form is used to collect individual case information 

which allows more thorough analysis of cases. For the purposes of these analyses, if either the race or 

ethnicity question was answered, the case was included. For example, if “white” race was marked, 

but ethnicity was left blank, the individual was counted as “non-Hispanic white.” 

Congenital syphilis cases were reported by state and city of residence of the mother for 1995 

through 2000. 

Chlamydia, gonorrhea, and syphilis prevalence monitoring 

Chlamydia and gonorrhea test positivity for women attending family planning clinics, prenatal clinics, Indian Health Service clinics, the National Job Training Program, the U.S. Army, and men and 

women entering jail and juvenile detention facilities was calculated by dividing the number of persons 

testing positive for chlamydia or gonorrhea (numerator) by the total number of persons screened for 

each disease (denominator) and was expressed as a percentage. Except for the National Job Training 

Program and Army screening data, the denominators for these data sources may include more than 

one test from the same individual if that person was tested more than once during a year. Various laboratory test methods were used for all of these data sources except the National Job Training Program 

and U.S. Army and, for most of the figures shown, no adjustments of test positivity were made based 

on laboratory test type and sensitivity. However, for Figure 8, the chlamydia test results for each test 

type were weighted to reflect the sensitivity of the test used.2 The weights used in this adjustment are 

the reciprocals of the sensitivities of the laboratory test methods used. These test-specific sensitivities 

were defined as the midpoints of the range of published values for the sensitivities for each technology 

type (e.g., non-amplified, nucleic acid amplification, and culture) based on expert consultation regarding test evaluation studies.3,4 Limitations of this adjustment include: unknown dates when laboratories changed tests, missing information on the test method, variation of test sensitivity within a 

technology type, and no adjustment for supplemental testing such as negative grey zone testing. 

For more details on chlamydia prevalence, refer to the following annual publication: Centers for 

Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2000 Supplement: 

130 Sources and Limitations of Data Appendix STD Surveillance 2000 
Chlamydia Prevalence Monitoring Project Annual Report 2000. Atlanta, GA: U.S. Department of 

Health and Human Services, Centers for Disease Control and Prevention, 2001 (in press). 

Data on antimicrobial susceptibility in Neisseria gonorrhoeae were collected through the Gonococcal Isolate Surveillance Project (GISP), a sentinel system of 25 STD clinics and five regional laboratories located throughout the United States. For more details on GISP gonorrhea cases, refer to the 

following annual publication: Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2000 Supplement: Gonococcal Isolate Surveillance Project (GISP) Annual Report 

2000. Atlanta, GA: U.S. Department of Health and Human Services, 2001(in press). 

Syphilis seroreactivity data on men and women entering jails and juvenile detention facilities were 

calculated by dividing the number of persons with a reactive syphilis serologic test (numerator) by the 

total number of persons screened for syphilis (denominator) and expressed as a percentage. These 

seroreactivity data in most instances do not reflect confirmatory testing and thus biologic false positive 

test results were not systematically excluded. The extent to which these data reflect prevalence of active syphilis infection varies by site. Further details from each site, including prevalence of high titer infections (> 1:8) which may be more indicative of active infection, are provided in Centers for Disease 

Control and Prevention. Sexually Transmitted Disease Surveillance 2000 Supplement: Syphilis 

Surveillance Annual Report 2000. Atlanta, GA: U.S. Department of Health and Human Services, 

2001(in press). 

Prevalence data for region- and state-specific figures were published with permission from the HHS 

Regional Infertility Prevention Programs, selected state STD prevention programs, the National Job 

Training Program, U.S. Department of Labor, U.S. Army, and the Indian Health Service. 

Definition of HHS Regions 

Health and Human Services (HHS) regions referred to in the text are as follows: Region I = Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont; Region II = New Jersey, New York, Puerto Rico, and U.S. Virgin Islands; Region III = Delaware, District of Columbia, 

Maryland, Pennsylvania, Virginia, and West Virginia; Region IV = Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee; Region V = Illinois, Indiana, 

Michigan, Minnesota, Ohio, and Wisconsin; Region VI = Arkansas, Louisiana, New Mexico, 

Oklahoma, and Texas; Region VII = Iowa, Kansas, Missouri, and Nebraska; Region VIII = Colorado, 

Montana, North Dakota, South Dakota, Utah, and Wyoming; Region IX = Arizona, California, 

Guam, Hawaii, and Nevada; and Region X = Alaska, Idaho, Oregon, and Washington. 

Other Data Sources 

The information on the number of initial visits to private physicians’ offices for sexually transmitted 

diseases was based on analysis of data from the National Disease and Therapeutic Index (NDTI) (machine-readable files or summary statistics for years 1966-2000). For more information on this database, contact IMS America, Ltd., 1725 Newton Street, NW Washington, D.C. 20010; Telephone: 

(703) 356-1269. 

The information on patients hospitalized for pelvic inflammatory disease or ectopic pregnancy was 

based on analysis of data from the National Hospital Discharge Survey (machine-readable files for 

years 1980-1999), an ongoing nationwide sample survey of short-stay hospitals in the United 

States, conducted by the National Center for Health Statistics. For more information, see Graves EJ; 

STD Surveillance 2000 Appendix Sources and Limitations of Data 131 
1988 Summary: National Hospital Discharge Survey; Advance data No. 185; Hyattsville (MD): National Center for Health Statistics, 1990. The National Hospital Ambulatory Medical Care Survey 

(NHAMCS-ER) (machine-readable files for 1995-1999) was used to obtain estimates of the number 

of emergency room visits for pelvic inflammatory disease among women ages 15 to 44. Data on 

HSV-2 seroprevalence among the non-institutionalized U.S. population were obtained from the National Health and Nutrition Examination Survey (NHANES). The estimates generated using these 

data sources (NHDS, NHAMCS, and NHANES) are based on statistical surveys and therefore have 

sampling variability associated with the estimates. 

Healthy People Year 2010 Objectives 

In January 2000, CDC released objectives for Healthy People 2010 (HP2010).5 The year 2010 rate 

objectives for the diseases addressed in this report are: primary and secondary syphilis–– 0.2 case per 

100,000 persons; congenital syphilis––1.0 case per 100,000 live births; and gonorrhea––19.0 cases 

per 100,000 persons. An additional target established in the HP2010 objectives is to reduce the 

Chlamydia trachomatis test positivity to 3.0% among females aged 15 to 24 years who attend family 

planning and STD clinics and among males aged 15 to 24 who attend STD clinics (Table A1). 

Urban-Rural Categorization Method 

Aggregate county-specific case report data on P&S syphilis are submitted monthly by state health 

departments (via Form CDC-73.998) to the Centers for Disease Control and Prevention (CDC). 

These P&S syphilis case report data were summarized using urban-to-rural continuum codes for 

metro and nonmetro counties that were developed by the U.S. Department of Agriculture (USDA)6 

and incorporated the Office of Management and Budget’s (OMB) official metro status based on the 

results of the 1990 Population Census.7 The 1993 urban-rural continuum codes form a classification 

scheme that distinguishes metropolitan counties by size, and nonmetropolitan counties by degree of 

urbanization and proximity to metro areas. The standard Office of Management and Budget (OMB) 

metro and nonmetro categories have been subdivided into four metro and six nonmetro categories.6 

The county-specific USDA codes used to place counties into urban-to-rural categories are as follows: 

U.S. Department of Agriculture Urban-to-Rural Continuum Codes for Metro and 

Nonmetro Counties (as of June 1993) 

Code Metro Counties: 

0 Central counties of metro areas of 1 million population or more 

1 Fringe counties of metro areas of 1 million population or more 

2 Counties in metro areas of 250,000 to 1 million population 

3 Counties in metro areas of fewer than 250,000 population 

Nonmetro Counties: 

4 Urban population of 20,000 or more, adjacent to a metro area 

5 Urban population of 20,000 or more, not adjacent to a metro area 

6 Urban population of 2,500 to 19,999, adjacent to a metro area 

7 Urban population of 2,500 to 19,999, not adjacent to a metro area 

8 Completely rural or fewer than 2,500 urban population, adjacent to a metro area 

9 Completely rural or fewer than 2,500 urban population, not adjacent to a metro area 

An aggregate urban category (codes 0, 2, and 3) was defined to include central counties with at 

least one million or more persons (code 0) and non-fringe counties in metro areas (codes 2 and 3). 

132 Sources and Limitations of Data Appendix STD Surveillance 2000 
Fringe metro counties (code 1) were combined with the nonmetro counties adjacent to a metro area 

and with an urban population of at least 2,500 population (codes 4 and 6) to form an aggregate category designated as peri-urban (codes 1, 4, and 6). An aggregate peri-rural category was defined to include nonmetro counties not adjacent to a metro area and with an urban population of at least 2,500 

population (codes 5 and 7), and an aggregate rural (codes 8 and 9) category was defined to include 

nonmetro counties that were completely rural or had fewer than 2,500 urban population. 

1Kaufman RE, Jones, OG, Blount, JH, Wiesner PJ. Questionnaire survey of reported early congenital syphilis: problems in diagnosis, prevention, and treatment. Sex Transm Dis 1977;4:135-9. 

2Webster Dicker L, Mosure DJ, Levine WC, Black CM, Berman SM. The impact of switching laboratory tests 

on reported trends in Chlamydia trachomatis infections. Am J Epidemiol 2000;151:430-435. 

3Newhall WJ, DeLisle, S, Fine D, et al. Head-to-head evaluation of five different non-culture chlamydia tests 

relative to a quality-assured culture standard. Sex Trans Dis 1994;21:S165-6. 

4Centers for Disease Control and Prevention. 2001 Guidelines for the Laboratory Detection of Chlamydia 

trachomatis (CT) and Neisseria gonorrhea (GC) Infections. (In preparation). 

5U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government Printing 

Office, November 2000. 

6Rural-Urban Continuum Codes for Metro and Nonmetro Counties, 1993. Butler MA, Beal CL, Agriculture 

and Rural Economy Division, Economic Research Service, U.S. Department of Agriculture. Staff Report No. 

AGES 9425, September 1994. 

7Federal Register, Part IV, Office of Management and Budget, Revised Standards for Defining Metropolitan 

Areas in the 1990’s. Vol .55 No.62, Friday March 30, 1990. 

STD Surveillance 2000 Appendix Sources and Limitations of Data 133 
Figure A1. Chlamydia — National Electronic Telecommunications System for Surveillance 

(NETSS) transmission status by state, 2000 

Guam NETSS Data: 

Summary 

Case 

Case Extended 

Discontinued 

Hardcopy 

Puerto Rico Virgin Is.* 

*Virgin Islands did not report. 

Note: Unless noted, large city projects transmit records in the same format as states. San Francisco 

and Los Angeles projects report case extended chlamydia records to NETSS. 

Figure A2. Gonorrhea — National Electronic Telecommunications System for Surveillance 

(NETSS) transmission status by state, 2000 

Guam NETSS Data: 

Summary 

Case 

Case Extended 

Discontinued 

Hardcopy 

Puerto Rico Virgin Is.* 

*Virgin Islands did not report. 

Note: Unless noted, large city projects transmit records in the same format as states. San Francisco 

and Los Angeles projects report case extended gonorrhea records to NETSS. 

134 NETSS Appendix STD Surveillance 2000 
Figure A3. Primary and secondary syphilis — National Electronic Telecommunications 

System for Surveillance (NETSS) transmission status by state, 2000 

Guam NETSS Data: 

Summary 

Case 

Case Extended 

Discontinued 

Hardcopy 

Puerto Rico Virgin Is.* 

*Virgin Islands did not report.
 

Note: Unless noted, large city projects transmit records in the same format as states.
 

STD Surveillance 2000 Appendix NETSS 135 
Table A1. Healthy People 2010 Sexually Transmitted Diseases Objective Status 

Objective 

Baseline 

Year Baseline 1997 1998 1999 2000 

2010 

Objective 

25-1 Reduce the proportion of adolescents and young 

adults with Chlamydia trachomatis infections 

a. Females aged 15 to 24 years attending family planning clinics 1997 5.0% 5.0% 6.1%* 5.6%* 5.9%* 3.0% 

b. Females aged 15 to 24 years attending STD clinics 1997 12.2% 12.2% 13.5%* 13.7%* 13.5%* 3.0% 

c. Males aged 15 to 24 years attending STD clinics 1997 15.7% 15.7% 16.9%* 17.0%* 16.4%* 3.0% 

25-2 Reduce gonorrhea (cases per 100,000 population) 1997 123.0 122.0 131.6 132.0 131.6 19.0 

25-3 Eliminate sustained domestic transmission of primary 

and secondary syphilis (cases per 100,000 

population) 

1997 3.2 3.2 2.6 2.4 2.2 0.2 

25-4 Reduce the proportion of adults aged 20 to 29 years 

with genital herpes infection 

1988-94 17.0% —-­ —­ —­ —­ 14.0% 

25-6 Reduce the proportion of females aged 15 to 44 years 

who have ever required treatment for pelvic 

inflammatory disease (PID) 

1995 8.0% —­ —­ —-­ —­ 5.0% 

25-7 Reduce the proportion of childless females with 

fertility problems who have had a sexually 

transmitted disease or who have required treatment 

for pelvic inflammatory disease (PID) 

1995 27.0% —­ —­ —­ —-­ 15.0% 

25-9 Reduce congenital syphilis (cases per 100,000 live 

births) 

1997 27.0 27.8 21.3 14.5 13.4 1.0 

—-Data not available.
 

NOTE: Data include revisions and, therefore, may differ from data previously published in these reports and other publications.
 

Data Sources 

Objective number Data Source 

25-1 Sexually Transmitted Disease Surveillance System, CDC, NCHSTP. 

25-2 Sexually Transmitted Disease Surveillance System, CDC, NCHSTP. 

25-3 Sexually Transmitted Disease Surveillance System, CDC, NCHSTP. 

25-4 National Health and Nutrition Examination Survey (NHANES), CDC, NCHS. 

25-6 National Survey of Family Growth (NSFG), CDC, NCHS. 

25-7 National Survey of Family Growth (NSFG), CDC, NCHS. 

25-9 Sexually Transmitted Disease Surveillance System, CDC, NCHSTP. 

*Positivity not adjusted for changes in laboratory test method in 1998-2000 and associated increases in test sensitivity. 

NOTE: Healthy People 2010 developmental objectives are not addressed in this report. 

136 Healthy People 2010 Appendix STD Surveillance 2000 
STD Project Directors, STD Program Managers, and State and Territorial Epidemiologists 

We gratefully acknowledge the contributions of state STD project directors, STD program managers, and state and territorial 

epidemiologists to this report. The persons listed were in the positions shown as of August 24, 2001. 

STD Project Directors STD Program Managers State Epidemiologists 

Alabama Charles H. Woernle Mike O’Cain J.P. Lofgren 

Alaska John P. Middaugh Donna Cecere John P. Middaugh 

Arizona Chris Brown Frank Slaughter Norman Peterson 

Arkansas Renee Patrick Gary Horton Thomas McChesney 

California Gail Bolan Tom Ault Duc J. Vugia 

Los Angeles Peter Kerndt A. Michael Lawrence Duc J. Vugia 

San Francisco Jeffrey Klausner Wendy Wolf Duc J. Vugia 

Colorado Ellen Mangione Terry Tiller-Taylor Richard E. Hoffman 

Connecticut James L. Hadler Heidi Jenkins James L. Hadler 

Delaware James C. Welch Kathleen O’Connor-Watson A. LeRoy Hathcock 

District of Columbia Andrew Schamess John Heath Martin E. Levy 

Florida Landis Crockett Karla Schmitt Richard S. Hopkins 

Georgia Kathleen Toomey Jack Kirby Paul Blake 

Hawaii Peter Whiticar Roy Ohye Paul Effler 

Idaho Roger Perotto Anne Williamson Christine G. Hahn 

Illinois Charlie Rabins Charlie Rabins Mark Dworkin 

Chicago Christine Kosmos Janice M. Johnson Mark Dworkin 

Indiana Michael Butler (acting) Jim Beall Robert Teclaw 

Iowa Mary Weaver John Katz Patricia Quinlisk 

Kansas Ganfranco Pezzino R. Allen Mayer Gianfranco Pezzino 

Kentucky Barry Wainscott David Raines Rice Leach (acting) 

Louisiana Jim Scioneaux Dennis Dorst Raoult Ratard 

Maine Sally Lou Patterson Bob Woods Kathleen F. Gensheimer 

Maryland Nancy Hoyt Scott Tulloch Jeffrey Roche 

Baltimore Ricardo Branic Glen Oltoff Jeffrey Roche 

Massachusetts Paul Etkind Paul Etkind Alfred DeMaria 

Michigan Loretta Davis-Satterla Mark A. Miller Matthew L. Boulton 

Minnesota Jill M. DeBoer Julia Ashley Harry Hull 

Mississippi Robert Hotchkiss Mike Cassell Mary Currier 

Missouri Mary Menges Mary Menges Eduardo Simoes 

Montana Bruce Deitle (acting) Bruce Deitle Todd A. Damrow 

Nebraska Christine M. Newlon Dan Harrah Thomas J. Safranek 

Nevada Yvonne Sylva Vener DeFriez Randall Todd 

New Hampshire David R. Ayotte David R. Ayotte Jesse Greenblatt 

New Jersey Janet DeGraaf Jerry Carolina Eddy A. Bresnitz 

New Mexico Susan Eastman Al Chowning Mack C. Sewell 

New York F. Bruce Coles F. Bruce Coles Perry F. Smith 

New York City Susan Blank Steve Rubin Perry F. Smith 

North Carolina Evelyn M. Foust Evelyn M. Foust Newton J. MacCormack 

North Dakota Larry Shireley Kirby Kruger Larry Shireley 

Ohio J. Nick Baird Juliet C. Davis-Williams Forrest W. Smith 

Oklahoma William R. Pierson Raymond A. Fugate Michael Crutcher 

Oregon Mark Loveless Jan Karius Melvin Kohn 

Pennsylvania Weston Ruhrig David Sullivan James T. Rankin, Jr. 

Philadelphia Robert Levenson Martin Goldberg James T. Rankin, Jr. 

Rhode Island Thomas E. Bertrand Thomas E. Bertrand Utpala Bandy 

South Carolina Lynda Kettinger Tim Lindman James Jerry Gibson 

South Dakota Laurie Gill David Morgan Sarah L. Patrick 

Tennessee William L. Moore, Jr. Drema Mace William L. Moore, Jr. 

Texas Casey S. Blass Casey S. Blass Dennis M. Perrotta 

Utah Craig R. Nichols John Contreras Robert T. Rolfs 

Vermont Peter D. Galbraith Marilyn Richards-Proulx Peter D. Galbraith 

Virginia Casey Riley Casey Riley Robert B. Stroube 

Washington Larry Klopfenstein Larry Klopfenstein John Kobayashi 

West Virginia Loretta E. Haddy Margaret Taylor Loretta E. Haddy 

Wisconsin Herb Bostrom Anthony Wade Jeffrey P. Davis 

Wyoming Jimm Murray Roger Burr Karl Musgrave 

American Samoa Joseph Tufa Tai Ripley Joseph Tufa 

Federated States of 

Micronesia Eliuel K. Pretrick Kidsen K. Iohp Jean Paul Chaine 

Government of the 

Marshall Islands Donald F. Copelle Peter Bien Tom D. Kijiner 

Guam Dennis Rodriguez Josie O’Mallen Robert L. Haddock 

Puerto Rico Angeles Rodriguez Trinidad Garcia Carmen Deseda 

Republic of Palau Uedo Masao Caleb T. Otto Jill McCready 

Virgin Islands Mavis Matthews Lois Sanders Vacant 

STD Surveillance 2000 Appendix Contributors 137